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Published on: August 8, 2022
Clinical Course and Predictors of Heart Failure in Asymptomatic Obstructive Hypertrophic Cardiomyopathy
Alexander Schulz1, Martin S Maron2, Lily W Peng1
1Department of Medicine (Cardiovascular Division) Beth Israel Deaconess Medical Center and Harvard Medical School Boston MA.
Journal of the American Heart Association
|July 3, 2026
Summary
In obstructive hypertrophic cardiomyopathy, impaired right ventricular stroke volume index predicts heart failure progression in asymptomatic patients. This finding aids in identifying individuals at higher risk for adverse outcomes.
Area of Science:
- Cardiology
- Cardiovascular Imaging
- Heart Failure Research
Background:
- Obstructive hypertrophic cardiomyopathy (oHCM) significantly impacts patient morbidity.
- Identifying risk factors for heart failure progression in asymptomatic oHCM is crucial for timely intervention.
Purpose of the Study:
- To identify predictors of adverse outcomes in asymptomatic patients with oHCM.
- To investigate the role of right ventricular function in disease progression.
Main Methods:
- Retrospective analysis of 341 asymptomatic oHCM patients (NYHA class I, LVEF >50%, LVOT gradient ≥30 mmHg).
- Transthoracic echocardiography and cardiovascular magnetic resonance imaging were performed.
- Cox regression analysis evaluated progression to NYHA class II+ or LVEF <50%.
Main Results:
- 29% of patients progressed to a combined adverse endpoint over a median of 4.4 years.
- Impaired right ventricular stroke volume index (RV-SVI) was an independent predictor of progression.
- Patients in the lowest RV-SVI quartile had a 2.5-fold higher risk of progression.
Conclusions:
- Approximately one-third of asymptomatic oHCM patients progressed to symptomatic heart failure within 5 years.
- Reduced RV-SVI is a novel, independent predictor of adverse events in oHCM.
- RV-SVI may assist in risk stratification and management decisions for oHCM patients.
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