Baseline symptom burden at referral was a powerful prognostic discriminator for long-term outcomes among 3,546 patients with obstructive hypertrophic cardiomyopathy undergoing surgical myectomy.
Cohort (n=3,546)
Does earlier surgical referral for surgical myectomy improve long-term outcomes in patients with obstructive hypertrophic cardiomyopathy compared to referral at advanced decompensation?
Earlier surgical referral for myectomy in obstructive hypertrophic cardiomyopathy, before advanced symptom decompensation, is associated with better long-term survival.
Surgical myectomy (SM), performed to relieve dynamic left ventricular outflow tract obstruction (LVOTO) in symptomatic obstructive hypertrophic cardiomyopathy (oHCM) patients provides improved quality of life and symptoms and excellent long-term survival. Guidelines recommend SM in symptomatic oHCM patients refractory to optimal medical therapy. We sought to assess whether SM in patients with fewer symptoms at initial referral is associated with improved long-term outcomes in oHCM. Baseline symptom burden at the time of referral emerged as a powerful prognostic discriminator among 3,546 HCM patients undergoing SM. Our findings suggest that earlier surgical referral before advanced decompensation may be associated with more favorable long-term outcomes. Women were more likely to present with advanced symptoms and had higher adjusted risk. These results underscore the need to determine whether a proactive therapeutic strategy, including an earlier intervention, can modify long-term survival in oHCM.
Jadam et al. (Thu,) conducted a cohort in obstructive hypertrophic cardiomyopathy (oHCM) (n=3,546). Surgical myectomy was evaluated on Long-term outcomes. Baseline symptom burden at referral was a powerful prognostic discriminator for long-term outcomes among 3,546 patients with obstructive hypertrophic cardiomyopathy undergoing surgical myectomy.