In asymptomatic obstructive hypertrophic cardiomyopathy, impaired right ventricular stroke volume index independently predicted progression to heart failure (HR 1.16 per 5-mL/m2 decrease; P=0.004).
Cohort (n=341)
Yes
Does impaired right ventricular stroke volume index predict progression to symptomatic heart failure in asymptomatic patients with obstructive hypertrophic cardiomyopathy?
In asymptomatic patients with obstructive hypertrophic cardiomyopathy, impaired right ventricular stroke volume index independently predicts progression to symptomatic heart failure.
Hazard Ratio: 1.16
p-value: p=0.004
Background Left ventricular outflow tract obstruction is a major contributor to morbidity in hypertrophic cardiomyopathy and an established therapeutic target. However, the risk factors driving progression to symptomatic heart failure in asymptomatic patients with obstructive hypertrophic cardiomyopathy remain incompletely understood. Methods We retrospectively identified 341 consecutive asymptomatic patients with obstructive hypertrophic cardiomyopathy (New York Heart Association class I, left ventricular ejection fraction >50%, left ventricular outflow tract gradient ≥30 mm Hg) across 4 centers between 2003 and 2023 (mean±SD age, 48±17 years; 78% men). All underwent transthoracic echocardiography and cardiovascular magnetic resonance. A combined adverse end point included progression to New York Heart Association class II or greater or development of systolic dysfunction (left ventricular ejection fraction 49 mL/m 2 ). Conclusions Among asymptomatic patients with obstructive hypertrophic cardiomyopathy in a large longitudinal cohort, approximately one‐third developed limiting symptoms over 5 years. Impaired right ventricular stroke volume index was a novel, independent predictor of future heart failure and may help identify high‐risk patients, with implications for management.
Schulz et al. (Fri,) conducted a cohort in Asymptomatic obstructive hypertrophic cardiomyopathy (n=341). Impaired right ventricular stroke volume index vs. Preserved right ventricular stroke volume index was evaluated on Progression to New York Heart Association class II or greater or development of systolic dysfunction (left ventricular ejection fraction <50%) (HR 1.16, p=0.004). In asymptomatic obstructive hypertrophic cardiomyopathy, impaired right ventricular stroke volume index independently predicted progression to heart failure (HR 1.16 per 5-mL/m2 decrease; P=0.004).