Survival and prognostic factors in hypertrophic cardiomyopathy: a meta-analysis

Abstract

Hypertrophic cardiomyopathy (HCM) is a clinically and genetically heterogeneous disorder but data on survival rates are still conflicting and have not so far been quantitatively reviewed. The aim of this study is to conduct a meta-analysis of cohort studies to assess pooled survival rates and prognostic factors for survival in patients with HCM. Nineteen studies were included representing 12,146 HCM patients. The pooled 1-, 3-, 5- and 10-year survival rates were 98.0%, 94.3%, 82.2% and 75.0%, respectively. Among patients with HCM, age, NYHA functional class, family history of sudden death (FHSD), syncope, atrial fibrillation, non-sustained ventricular tachycardia (nsVT), maximum left ventricular wall thickness and obstruction were significant prognostic factors for cardiovascular death. For sudden cardiac death, FHSD, nsVT, and obstruction showed significant predictive values. Moreover, estimation of population attributable risk (PAR) suggested that nsVT was the strongest predictor for cardiovascular death (13.02%, 95% CI 3.60–25.91%), while left ventricular outflow tract obstruction/mid-ventricular obstruction (LVO/MVO) was the strongest predictor for all-cause death and sudden cardiac death (10.09%, 95% CI 4.72–20.42% and 16.44%, 95% CI 7.45–31.55%, respectively). These risk factors may thus be useful for identifying HCM patients who might benefit from early diagnosis and therapeutic interventions.

U-shaped association between serum uric acid concentration and mortality in hypertrophic cardiomyopathy patients

“…And thus the U-shaped association between SUA concentrations and all-cause mortality and HCM-related mortality in HCM patients is credible to some extent. Second, the mortality rate in the present study is higher than in previous studies (11), which might be partially explained by collection bias of patients. All patients were enrolled at the inpatient department of a tertiary referral hospital, and their diseases might be more severe than general HCM populations.…”

“…Some factors have been identified for risk stratification in HCM patients, such as New York Heart Association (NYHA) class, atrial fibrillation (AF), maximal wall thickness (MWT), and left ventricular outflow tract obstruction (LVOTO), etc. (11). In a retrospective cohort study, Zhu et al illustrated that high SUA concentrations were associated with adverse outcomes in HCM patients (12).…”

Efficacy and safety of radiofrequency ablation for hypertrophic obstructive cardiomyopathy: A systematic review and meta‐analysis

“…Population‐based studies estimated that the prevalence of HOCM was 0.02% to 0.23% in adults . The morbidity and mortality were higher in a population with LVOT obstruction than in that without …”

Inherited cardiomyopathies

“…When discussing prognosis with patients, tailor advice to the individual, including for clinical presentation, genetic causes, and evolving evidence based therapies. In HCM, 75% of patients live for at least 10 years following presentation (95% confidence interval 71.1 to 78.9%) as per a recent meta-analysis 59. This analysis, however, has several limitations and larger prospective studies with longer follow-up are required.…”