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Short- and Long-Term Outcomes of Obstructive and Non-Obstructive Hypertrophic Cardiomyopathy: A Systematic Review and

Hui Zhen Lo1, Chen Ee Low2, Chun En Yau3

  • 1Peninsula Health, Frankston, Vic, Australia.

Heart, Lung & Circulation
|July 23, 2025
PubMed

Insights

Obstructive hypertrophic cardiomyopathy (HOCM) increases sudden cardiac death risk compared to non-obstructive (NOCM) forms. While NOCM patients face higher overall mortality incidence, HOCM is linked to increased heart failure mortality.

Area of Science:

  • Cardiology
  • Genetics
  • Public Health

Background:

  • Hypertrophic cardiomyopathy (HCM) is a common inherited cardiac condition.
  • Risk factors and outcomes for obstructive (HOCM) and non-obstructive (NOCM) hypertrophic cardiomyopathy are not fully understood.
  • This study investigates mortality in HOCM versus NOCM patients.

Purpose of the Study:

  • To compare mortality risks and incidence between obstructive and non-obstructive hypertrophic cardiomyopathy.
  • To identify specific risk factors for all-cause and HCM-specific mortality.
  • To provide a comprehensive analysis of outcomes in HCM subtypes.

Main Methods:

  • A systematic review and meta-analysis adhering to PRISMA guidelines.
  • Searched PubMed, SCOPUS, and Embase databases for studies from 2001 to 2023.
  • Utilized random effects meta-analyses and meta-regressions for primary analysis.

Main Results:

  • Included 61 studies with 52,020 participants.
  • Sudden cardiac death (SCD) risk was significantly higher in HOCM versus NOCM patients (RR 1.69).
  • NOCM patients had higher incidence of all-cause, HCM-related, and SCD mortality; HOCM patients had higher heart failure-related mortality.

Conclusions:

  • Obstructive hypertrophic cardiomyopathy is associated with a significantly higher risk of sudden cardiac death.
  • Non-obstructive hypertrophic cardiomyopathy presents a higher incidence of all-cause, HCM-related, and sudden cardiac death mortality.
  • Heart failure-related mortality is the primary concern in obstructive hypertrophic cardiomyopathy.
Abstract

Keywords:
Hypertrophic cardiomyopathyNon-obstructiveObstructiveOutcomes

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