Apical hypertrophic cardiomyopathy carries a significant risk of adverse clinical events, which can be predicted using a combination of clinical, echocardiographic, and cardiac MRI markers.
Abstract Purpose: The clinical prognosis of apical hypertrophic cardiomyopathy (ApHCM) is still controversial in the previous study. Moreover, there are limited studies on the prognostic risk factors of ApHCM. The present study aimed to observe the clinical prognosis of ApHCM and to identify the predictors of poor prognosis in clinical, echocardiographic and cardiac magnetic resonance imaging. Methods： A total of 126 patients with ApHCM were identified retrospectively from January 2008 to December 2018. Adverse events were defined as a composite of cardiac death, progressive heart failure, myocardial infarction, thromboembolic stroke, appropriate implantable cardioverter-defibrillator (ICD) interventions for ventricular tachycardia or ventricular fibrillation, and new-onset atrial fibrillation (AF). Results: During a mean follow-up of 96.8±36.0 months, clinical events were observed in 34 (27.0%) patients. The patients who experienced events were older and had higher incidence of heart failure. The patients with clinical events had higher incidence of non-sustained ventricular tachycardia and had larger LAVI and thicker apical thickness than those without clinical events, and were more frequently with LGE presence. The peak systolic mitral annular velocity (s’) was higher in patients with clinical events patients with events. Conclusions: ApHCM was not as benign as expected. Age≥55 years，LAVI≥36.7 ml/m 2 , s’≤6.7cm/s along with NSVT and LGE were independent risk factor for poor prognosis of ApHCM.
Yin et al. (Sat,) studied this question.