Survival and Clinical Behavior of Hypertrophic Cardiomyopathy in a Latin American Cohort in Contrast to Cohorts from the Developed World

Abstract

BackgroundHypertrophic cardiomyopathy (HCM) is the most common hereditary heart disease with diverse phenotipyc, genetic expession and clinical presentations. The evolution of patients with HCM in Latin America has not been properly described being the frequency, the long-term prognosis as well as the predominant phenotypic expression still unknown. The aim of this study was to determine the survival rate of HCM patients having different phenotypes in a Mexican cohort of patients.MethodsClinical and echocardiographic data obtained from 77 Mexican patients with recently diagnosed HCM were analyzed. The follow-up was of 12.5 years.Results96.1% of patients were in functional class I/II according to the New York Heart Association, 2.6% in class III and 1.3% in class IV. Only 3.9% of them went to surgery for myectomy. During the follow-up, 17 patients (22%) died: 4/9 (44%) had apical HCM, 5/20 (25%) had obstructive septal asymmetric HCM, 6/35 (17%) had nonobstructive septal asymmetric HCM and 2/3 (15%) had concentric HCM. The survival rate was worse for patients with apical HCM, followed by those with obstructive and nonobstructive septal asymmetric HCM and patients showing concentric HCM had the best survival rates. There is significant difference in survival rates which declined in 65% in a 9 years-period. Log rank test showed significant differences (p < 0.002).ConclusionThe survival rate of patients with HCM was worse in those with apical variety. The majority of patients received medical treatment. The indication for myectomy was below that observed in other international centers.

Evaluation of LVEF with Changing left Ventricular Morphology in Hypertrophic Cardiomyopathy

“…16 LVEF in concentric HCM was higher than other types of HCM in present study (72.30%), whereas LVEF in asymmetric septal HCM was higher in a study by Espinola-Zavaleta (67%). 17 The values found in this study was significant among the cardiac phenotypes of HCM.…”

“…Espinola-Zavaleta et al found the interventricular septal thickness in concentric HCM was lower than asymmetric septal HCM. 11 However, we found that in our study population interventricular septal thickness this two group was almost similar. The overall value observed in this study was similar to that of the other reviews.…”

The Brazilian Society of Cardiology and Brazilian Society of Exercise and Sports Medicine Updated Guidelines for Sports and Exercise Cardiology - 2019

“… 93 For hypertrophy between 13 and 14 mm, other factors, such as family history, specific ECG changes, symptoms, another imaging method and even genetic evaluation should be considered in the differential diagnosis. 94 In first-degree relatives of a HCM patient, hypertrophy greater than 13 mm is also highly indicative of this disease. 91 Hypertrophy related to pressure overload, physical training and basal septal hypertrophy in the elderly should be considered in the differential diagnosis.…”

Mechanical dyssynchrony and diastolic dysfunction are common in LVH: a pilot correlation study using Doppler echocardiography and CZT gated-SPECT MPI

“…HCM is an often under-diagnosed disease 7 , with an estimated prevalence of approximately 1/500 of the general population. It is equally present in both men and women, and can affect any age group 8 , 9 .…”