Impact of peak provoked left ventricular outflow tract gradients on health-related quality of life in patients with hypertrophic cardiomyopathy: a real-world cross-sectional survey

Background Hypertrophic cardiomyopathy (HCM) causes substantial symptoms that can significantly impact quality of life (QoL). Elevated provoked left ventricular outflow tract gradients (LVOT-G) are linked to worse symptoms, more cardiovascular events, and poorer long-term outcomes, but their relationship with QoL remains unclear. Purpose To evaluate the association between LVOT-G, QoL and work productivity in patients with HCM. Methods Data were drawn from the Adelphi Real World HCM Disease Specific Programme™, a real-world, cross-sectional survey with retrospective data collection in Italy, Spain and United States between 2022-2024. Patients with HCM were classified into three groups based predefined LVOT-G- Group 1: <30mmHg; Group 2: ≥30 – <90 mmHg; and Group 3: ≥90 mmHg. QoL was measured using EQ-5D-5L, EQ-VAS scores, and the Kansas City Cardiomyopathy Questionnaire (KCCQ-23). Work productivity was measured using the work productivity and activity impairment questionnaire (WPAI). Mean values of QoL and work productivity were reported. Spearman’s rank, Kruskal-Wallis, and Mann-Whitney assessed associations between disease progression as measured using LVOT-G, and outcomes. Results Of 1248 patients (mean age, 55.82 years; 61.30% were male), 63.62% had LVOT-G≥30 mmHg. Patient demographics and clinical characteristics are summarized in Table 1. Mean KCCQ overall summary scores decreased significantly with increasing LVOT-G (G1=82.28, G2=75.20, G3=47.98, p<0.05). Similarly, mean KCCQ clinical summary scores decreased significantly with increasing LVOT-G (G1=84.01, G2=78.05, G3=55.08, p<0.05) (Table 2). Higher LVOT-G was significantly associated with lower mean EQ-5D-5L and EQ-VAS scores (p<0.05 for both) (Table 2). Activity impairment, work-related activity impairment, and overall work impairment due to HCM all significantly increased with rising LVOT-G, as measured by the WPAI (all p<0.05) (Table 2). Conclusions In patients with HCM, QoL and work productivity deteriorated with disease progression, as measured by LVOT-G. Effective treatments that help lower LVOT-G and improve patient outcomes are needed to reduce the humanistic burden of HCM for patients.