Key result
Beta-blocker therapy linked to slower LV wall thickening in patients with HCM.
Why the study?
Hypertrophic cardiomyopathy causes abnormal left ventricular myocardial thickening and sudden death, but longitudinal cardiac remodeling and the impact of different treatment regimens on disease progression needed investigation.
Does beta-blocker therapy reduce the rate of adverse cardiac remodeling (left ventricular wall thickening) in patients with hypertrophic cardiomyopathy?
Observational (n=100)
Single-blind (outcome assessors)
None
No
Does beta-blocker therapy reduce the rate of adverse cardiac remodeling (left ventricular wall thickening) in patients with hypertrophic cardiomyopathy?
p-value: p=<0.001
In patients with hypertrophic cardiomyopathy, beta-blocker therapy is associated with a significantly slower rate of progressive left ventricular wall thickening over 24 months, suggesting a potential disease-modifying effect on cardiac remodeling.
May attenuate remodeling in HCM; hypothesis-generating and requires RCTs before practice change.
BACKGROUND: Hypertrophic cardiomyopathy (HCM) is a hereditary cardiac disorder characterized by abnormal thickening of the left ventricular myocardium. This can lead to various clinical manifestations, including sudden death. AIM: To investigate the cardiac remodeling and functional changes in patients with HCM over a specific time period and explore the impact of different treatment regimens on disease progression. METHODS: We conducted a prospective longitudinal observational study involving 100 patients diagnosed with HCM. Baseline clinical data, including demographics, medical history, and echocardiographic measurements, were collected. Follow-up assessments were performed at regular intervals over 24 months to track changes in cardiac structure, function, and clinical status. Statistical analysis, including paired t-tests and subgroup analysis, was conducted to identify significant associations and differences between treatment groups. RESULTS: A total of 100 patients (mean age = 55 years, 50% male) were enrolled in the study. At baseline, echocardiography revealed increased left ventricular wall thickness (mean = 18.5 mm), left atrial dimensions (mean = 39 mm), and ventricular mass (mean = 230 g). During the follow-up period, there was a progressive increase in left ventricular wall thickness (mean change = 1.0 mm/year, p < 0.001), left atrial dimensions (mean change = 3.0 mm/year, p < 0.001), and ventricular mass (mean change = 8 g/year, p = 0.003). Additionally, alterations in diastolic and systolic function parameters were noted, with a decline in E/A ratio (mean change = -0.1 units/year, p = 0.008) and a reduction in ejection fraction (mean change = -2.0% per year, p = 0.001). CONCLUSION: Our longitudinal observational study provides important insights into the cardiac remodeling and functional changes in patients with HCM over time. The progressive increase in cardiac parameters indicates ongoing disease progression. Additionally, beta-blocker therapy was associated with a slower rate of left ventricular wall thickening. These findings contribute to a better understanding of HCM's natural history and may guide targeted therapeutic approaches to improve patient outcomes.
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Reddy et al. (2023) conducted an observational in Hypertrophic cardiomyopathy (n=100). Observation was evaluated on Change in left ventricular wall thickness (mm/year) (p=<0.001). In patients with hypertrophic cardiomyopathy, left ventricular wall thickness progressively increased by a mean of 1.0 mm/year over 24 months, with beta-blocker therapy associated with a slower rate of thickening.
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