Clinical features and prognosis of obstructive and non-obstructive hypertrophic cardiomyopathy patients

Abstract

Abstract: AIM: To compare and analyse the clinical features and outcomes between obstructive and non-obstructive hypertrophic cardiomyopathy (HCM). METHODS: We made a retrospective analysis of the clinical data of 112 patients(54 patients were obstructive HCM and 58 patients were non-obstructive HCM)) admitted in our hospital from 2003 to 2006 with the diagnosis of HCM, and followed up for (4.5 ±2.8) years.RESULTS: There were no significant differences in age, family history and complications between obstructive and non-obstructive HCM patients.The proportion of female patients was markedly higher in the obstructive HCM patients than that in the non-obstructive HCM patients.Besides chest distress and heart murmur were more obvious in the obstructive HCM patients, there was no significant difference between the two groups as to other clinical symptoms, signs and clinical outcome.The differences in systolic anterior motion of the mitral valve(SAM sign), maximum pressure gradient in the left ventricular outflow tract (LVOT), left ventricular ejection fraction(LVEF), left atrial diameter, mitral valve regurgitation reached sinificance between the obstructive HCM group and the non-obstructive HCM group.The incidence of clinical events was low in follow-up period, and there was no difference between the two groups.CONCLUSION: There were no significant differences in age, family history and, complications between obstructive and non-obstructive HCM patients.After β blocker-based drug treatment, the incidence of clinical and cardiac events were relatively low.

Key words: obstructive hypertrophic cardiomyopathy, non-obstructive hypertrophic cardiomyopathy, clinical outcome

CLC Number:

R542.2

TANG Yuan-yuan, TANG Bo-jian, YAN Xiao-wei, FANG Quan. Clinical features and prognosis of obstructive and non-obstructive hypertrophic cardiomyopathy patients[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2009, 14(2): 195-198.

References

[1] 中华医学会心血管病学分会, 中华心血管病杂志编辑委员会, 中国心肌病诊断与治疗建议工作组.心肌病诊断与治疗建议[J].中华心血管病杂志, 2007, 35(1):5-16.
[2] Maron BJ, McKenna WJ, Danielson GK, et al.American College of Cardionogy European Soaety of cardiology. Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy:a report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines[J].Eur Heart J, 2003, 24 (21):1965-1991.
[3] Maron BJ, Gardin JM, Flack JM, et al.Prevalence of hypertrophic cardiomyopathy in a general population of young adults:Echocardiographic analysis of 4111 subjects in the CARDIA Study[J].Circulation, 1995, 92(4):785-789.
[4] Maron BJ, Casey SA, Poliac LC, et al.Clinical course of hypertrophic cardiomyopathy in a regional United States cohort[J].JAMA, 1999, 281(7):650-655.
[5] Maron MS, Olivotto I, Betocchi S, et al.Effects of left ventricular outflow tract obstruction on clinical outcome in hypertrophic cardiomyopathy[J].N Engl J Med, 2003, 348(4):295-303.
[6] Zou Y, Song L, Wang Z, et al.Prevalence of idiopathic hypertrophic cardiomyopathy in China:a population-based echocardiographicanalysis of 8080 adults[J].Am J Med, 2004, 116(1):14-18.
[7] Olivotto I, Maron MS, Adabag AS, et al.Gender-related differences in the clinical presentation and outcome of hypertrophic cardiomyopathy[J].J Am Coll Cardiol, 2005, 46(3):480-487.
[8] Wynne J, Braunwald E.The Cardiomyopathies[M] Zips D, Libby L, Bonow R, et al.eds.Braunwald's Heart Disease.ed 7.Philadelphia:Elsevier Saunders Publishers, 2005:1659-1717.
[9] Olivotto I, Cecchi F, Casey SA, et al.Impact of atrial fribrillation on the clinical course of hypertrophic cardiomyopathy[J].Circulation, 2001, 104(21):2517-2524.
[10] Higashikawa M, Nakamuri Y, Yoshida M, et al.Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fribrillation [J].Jpn Circ J, 1997, 61(8):673-681.
[11] Cecchi F.Does LV outflow tract obstruction increase the risk of sudden death in hypertrophic cardiomyopathy[J] ? Nat Clin Prac CardiovasMed, 2007, 4(4):194-195.
[12] Elliott PM, Gimeno JR, Tome MT, et al.Left ventricular outflow tract obstruction and sudden death risk in patients with hypertrophic cardiomyopathy[J].Eur Heart J, 2006, 27(16):1933-1941.