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Factors Affecting Clinical Outcome for Patient with Hypertrophic Cardiomyopathy

Purpose: To predict a poor outcome for a patient with hypertrophic cardiomyopathy (HCM) based on the study of Maron et al.

Description

Maron et al evaluated patients with hypertrophic cardiomyopathy. They identified risk factors for severe symptoms or death which can help to identify a patient who may benefit from more aggressive management. The authors are from Tufts-New England Medical Center, Azienda Ospedaliera Careggi (Florence), Federico II University of Naples, and the Minneapolis Heart Institute Foundation.


 

Patient selection: hypertrophic cardiomyopathy (HCM) with NYHA Class 0 to II

 

Outcome: progression to NYHA Class III or IV, death from heart failure and/or death from stroke at 10 years

 

With obstruction to outflow from the left ventricle a pressure gradient developed between the left ventricular chamber and the ascending aorta.

 

Parameters:

(1) peak instantaneous left ventricular outflow gradient in mm Hg during rest using continuous wave Doppler echocardiography

(2) age of the patient in years

Pressure Gradient

Age of the Patient

10 Year Probability of Outcome

< 30 mm Hg

< 40 years

15%

< 30 mm Hg

>= 40 years

20%

>= 30 mm Hg

< 40 years

38%

>= 30 mm Hg

>= 40 years

68%

 

The magnitude of the pressure gradient above the cutoff did not impact outcome.

 

The presence of pressure gradient >= 30 mm Hg was also associated with increased risk for sudden death.

 


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Specialty

Objective

ICD-10