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Long-term outcomes after septal reduction therapy for obstructive hypertrophic cardiomyopathy: a nationwide cohort

Andreas Schelldorfer1,2, Rahel Laager2,3, Laurent M Haegeli1,4

  • 1Department of Cardiology, Cantonal Hospital Aarau, Tellstrasse 25, 5001 Aarau, Switzerland.

European Heart Journal Open
|April 23, 2026
PubMed

Insights

Septal reduction therapies (SRT) for obstructive hypertrophic cardiomyopathy (HCM) show reduced mortality and heart failure rehospitalization compared to non-obstructive HCM. Outcomes after SRT are comparable to general surgical controls.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery

Background:

  • Obstructive hypertrophic cardiomyopathy (HCM) poses significant risks.
  • Septal reduction therapies (SRT) are established treatments for obstructive HCM.
  • Novel pharmacological options are emerging, necessitating updated outcome data for SRT.

Purpose of the Study:

  • To evaluate the long-term national outcomes of patients with obstructive HCM undergoing SRT.
  • To compare SRT outcomes against non-obstructive HCM patients and healthy surgical controls.

Main Methods:

  • Nationwide cohort study (2015-2021) using propensity score matching.
  • Compared 125 obstructive HCM patients undergoing SRT with 743 non-obstructive HCM patients.
  • Compared 126 obstructive HCM patients undergoing SRT with 560 surgical controls (appendectomy).

Main Results:

  • SRT significantly reduced the composite outcome of mortality and heart failure rehospitalization versus non-obstructive HCM (HR 0.17).
  • The incidence rate of the primary outcome was 12.62 per 1000 patient-years post-SRT versus 74.86 per 1000 patient-years in the non-obstructive HCM group.
  • SRT outcomes were comparable to surgical controls without heart disease (HR 1.53).

Conclusions:

  • SRT is associated with favorable long-term outcomes in obstructive HCM.
  • SRT demonstrates a lower incidence of mortality and heart failure rehospitalization compared to non-obstructive HCM.
  • The safety profile of SRT is comparable to general surgical procedures in healthy individuals.
Abstract

Keywords:
Follow-upHypertrophic cardiomyopathyNationwideOutcomesSeptal reduction therapy

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