Key result
Myocardial bridging in HCM is not associated with worse 5-year survival or sudden cardiac death.
Why the study?
Myocardial bridging has been associated with an adverse prognosis in pediatric HCM patients, but its prognostic impact on sudden cardiac death and other mortality in adult patients with HCM was unknown.
Does the presence of myocardial bridging increase the risk of all-cause mortality, cardiac death, or sudden cardiac death in adult patients with hypertrophic cardiomyopathy?
Cohort (n=425)
No
Does the presence of myocardial bridging increase the risk of all-cause mortality, cardiac death, or sudden cardiac death in adult patients with hypertrophic cardiomyopathy?
In adult patients with hypertrophic cardiomyopathy, myocardial bridging diagnosed at coronary angiography is not associated with an increased risk of all-cause mortality, cardiac death, or sudden cardiac death.
Hypothesis-generating for myocardial bridging in HCM; prospective studies needed before clinical adoption.
OBJECTIVES This investigation examined the risk of sudden cardiac death and other mortality in adult patients with hypertrophic cardiomyopathy (HCM) who have myocardial bridging diagnosed at coronary angiography. BACKGROUND Several reports have associated myocardial bridging with an adverse prognosis in pediatric HCM patients, but the prognosis of myocardial bridging in adult patients with HCM is unknown. METHODS The coronary angiograms of 425 patients with HCM (mean age 60 +/- 15 years [range 18 to 89 years]) at the Mayo Clinic were examined for the presence of myocardial bridging. Clinical follow-up was conducted to assess mortality. Survival of patients with bridging was compared with HCM patients who also underwent angiography but who did not have evidence of bridging. RESULTS A total of 64 patients (15%) had myocardial bridging. The mean follow-up for the entire study was 6.8 +/- 5.4 years. There was no difference in survival free of all-cause mortality (5-year estimate, bridging vs. no bridging, 91% vs. 85%; p = 0.42), all cardiac death (93% vs. 89%; p = 0.60), and sudden cardiac death (95% vs. 97%; p = 0.72). Univariate and multivariate proportional hazards models also did not identify the presence of bridging or specific characteristics of the degree or extent of bridging with a poor outcome. CONCLUSIONS This study observed no increased risk of death, including sudden cardiac death, among adult patients with HCM who had myocardial bridging diagnosed at coronary angiography.
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Sorajja et al. (2003) conducted a cohort in Hypertrophic cardiomyopathy (n=425). Myocardial bridging vs. No myocardial bridging on coronary angiography was evaluated on 5-year survival free of all-cause mortality (p=0.42). Myocardial bridging in adults with HCM was not associated with decreased 5-year survival free of all-cause mortality (91% vs. 85%, p=0.42) or sudden cardiac death (95% vs. 97%, p=0.72).
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