Clinical Characteristics and Cardiac Events in Elderly Patients with Apical Hypertrophic Cardiomyopathy.

Suganuma, Yukako; Shinmura, Ken; Hasegawa, Hiromasa; Tani, Masanao; Nakamura, Yoriyuki

doi:10.3143/geriatrics.34.474

Cited by 8 publications

(5 citation statements)

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“…Its natural course is known to be benign; however, some controversial data has been reported in Japanese and western AHCM populations, including the occurrence of SCD and apical aneurysms. 5) 14) 16) Eriksson et al 5) reported the long-term clinical outcomes of AHCM in a comparatively large number of patients (Canada, n=105) for a mean follow-up period of 13.6 years; they demonstrated a low mortality but an increased rate of CV events, including myocardial infarction (10%) and atrial fibrillation (12%), as compared to the general population. Thus, AHCM was shown to have a benign prognosis; however, it was associated with an increased rate of CV events, including 11 cases of myocardial infarction.…”

Section: Discussionmentioning

confidence: 99%

Impact of Coronary Artery Anatomy on Clinical Course and Prognosis in Apical Hypertrophic Cardiomyopathy: Analysis of Coronary Angiography and Computed Tomography

et al. 2015

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Background and ObjectivesApical hypertrophic cardiomyopathy (AHCM) is an uncommon variant of hypertrophic cardiomyopathy with a relatively benign course. However, the prognostic factors of AHCM-particularly those associated with coronary artery disease (CAD) and its anatomical subtypes-are not well known.Subjects and MethodsWe enrolled 98 consecutive patients with AHCM who underwent coronary angiography or coronary computed tomography scanning at two general hospitals in Korea from January 2002 to March 2012. Patient charts were reviewed for information regarding cardiovascular (CV) risk factors, symptoms, and occurrence of CV events and/or mortality. We also reviewed echocardiographic data and angiography records.ResultsThe mean age at the time of enrollment was 61.45±9.78 years, with female patients comprising 38.6%. The proportions of mixed and pure types of AHCM were 34.4% and 65.6%, respectively. CAD was found in 31 (31.6%) patients. The mean follow-up period was 53.1±60.7 months. CV events occurred in 22.4% of patients, and the mortality rate was 5.1%. The mixed-type was more frequent in CV event group although this difference was not statistically significant (50% vs. 30%, p=0.097). The presence of CAD emerged as an independent risk factor for CV events in univariate and multivariate Cox regression analysis after adjusting for other CV risk factors.ConclusionCoronary artery disease is an independent risk factor for CV events in AHCM patients. However, AHCM without CAD has a benign natural course, comparable with the general population.

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Section: Discussionmentioning

confidence: 99%

Impact of Coronary Artery Anatomy on Clinical Course and Prognosis in Apical Hypertrophic Cardiomyopathy: Analysis of Coronary Angiography and Computed Tomography

et al. 2015

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“…Ежегодная сердечно-сосудистая смертность для этих пациентов составила 0,1 % [22]. Большой ди-астолический размер ЛЖ также может предсказывать сердечные события у пациентов с AГКМП [57].…”

Section: течениеunclassified

Апікальна Гіпертрофічна Кардіоміопатія. Клінічний Випадок І Огляд Літератури

Nesukai

Adarichev

Titov

et al. 2022

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У статті наведено опис клінічного випадку апікальної гіпертрофічної кардіоміопатії у пацієнта 60 років. Детально обговорюються діагностика і вибір тактики лікування з урахуванням даних досліджень, описаних у літературі.

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“…8,9,18,19 Although the prevailing consensus is that AHC has a benign prognosis, [11][12][13][14] there is emerging data showing increased risk for sudden cardiac arrest, fatal arrhythmias, heart failure, and ischemic events in patients with AHC. [19][20][21][22][23][24][25] A recent study showed a substrate for monomorphic ventricular tachycardia to exist within the hypertrophied muscle component of AHC. 24 Management of this condition includes watchful waiting, medical treatment, or invasive interventions such as myomectomy, arrhythmia ablation, and intracardiac cardioverter defibrillator (ICD) placement.…”

Section: Discussionmentioning

confidence: 99%

Apical Hypertrophic Cardiomyopathy Presenting as Recurrent Unexplained Syncope

Kasirye¹,

Manne²,

Epperla³

et al. 2011

Clinical Medicine & Research

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A 47-year-old man was referred from an outside facility with complaints of recurrent falls. He had been referred to a neurologist for evaluation of recurrent unexplained syncope. Each event was non-convulsive, random, and preceded by a sudden loss of balance that would progress to falling due to altered mental status. There was no apparent triggering factor, post-event confusion, or loss of either bowel or urinary continence. He had been evaluated twice at a local healthcare facility for these falls, but no cause was identified.He was referred to us on the third presentation after suffering multiple facial and thoracic injuries. He had no evident cardiopulmonary symptoms. Because he was adopted, he had no knowledge of any family history history of cardiac events. His past medical history included bipolar disorder, tobacco abuse, alcohol dependence, and atypical facial pain. His home medications were carbamazepine, lamotrigine, olanzepine, diazepam, and venlafaxine. The only recent change in his medications was a carbamazepine dose reduction because a provider at an outside facility had thought that this might be contributing to his symptoms. On review of his past medical records (more than 10 years prior), left ventricular hypertrophy had been mentioned, but it had not been followed-up in subsequent evaluations. Previous computerized tomography (CT) of the head and neck had been unremarkable.Clinically, the patient was alert, awake, and oriented. Blood pressure was 123/63 mmHg, pulse 83 beats/minute, temperature 99.6ºF, respirations 20 breaths/ minute, and oxygen saturation 95% on room air. He had no orthostatic hypotension. The physical examination was normal except for the multiple facial swellings and left-sided chest wall tenderness he had sustained from the falls. Apical hypertrophic cardiomyopathy (AHC) is a rare variant of hypertrophic cardiomyopathy. Since its description by Sakamoto in 1976 in Japanese patients, our understanding of this entity has evolved. Although cardiac magnetic resonance imaging has emerged as the gold standard for diagnosing AHC, clinical attention must be drawn to the unique electrocardiographic features that provide the initial clues to making the diagnosis. In this case, we present a 47-year-old man with AHC who presented with recurrent syncope, but anomalies on his electrocardiogram went unnoticed on two clinical encounters. He was subsequently admitted to our service and rapidly diagnosed after we observed the very classical findings in the plain twelve lead electrocardiogram done at the time of admission. In a clinical encounter involving a patient presenting with recurrent syncope, special attention must be focused on the electrocardiogram to decipher the unique diagnostic features it might show.

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Clinical Characteristics and Cardiac Events in Elderly Patients with Apical Hypertrophic Cardiomyopathy.

Cited by 8 publications

References 0 publications

Impact of Coronary Artery Anatomy on Clinical Course and Prognosis in Apical Hypertrophic Cardiomyopathy: Analysis of Coronary Angiography and Computed Tomography

Impact of Coronary Artery Anatomy on Clinical Course and Prognosis in Apical Hypertrophic Cardiomyopathy: Analysis of Coronary Angiography and Computed Tomography

Апікальна Гіпертрофічна Кардіоміопатія. Клінічний Випадок І Огляд Літератури

Apical Hypertrophic Cardiomyopathy Presenting as Recurrent Unexplained Syncope

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