Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy

Maria Beatrice Musumeci, Domitilla Russo, Luca Rosario Limite, Marco Canepa, Giacomo Tini, Matteo Casenghi, Pietro Francia, Carmen Adduci, Erika Pagannone, Damiano Magrì, Massimo Volpe, Camillo Autore

Research output: Contribution to journalArticle

Abstract

In hypertrophic cardiomyopathy (HC), a process of left ventricular (LV) remodeling carrying an adverse prognosis has been described. Conversely, a gradual and benign LV wall thinning has been suggested but never investigated. Therefore, we studied a HC cohort over a long period of time to evaluate the occurrence of a LV remodeling with a benign clinical course. Data of HC patients aged 18 to 65 years and without any condition known to influence LV remodeling were analyzed over a mean follow-up of 7.6 ± 5.7 years. Of 231 HC patients (65% males, mean age 46 ± 12 years), 47 (20%) developed LV remodeling, of whom 23 (10%) had a thinning ≥15% of LV maximal wall thickness from baseline without systolic dysfunction (MWT thinning); 13 (6%) progressed to a LV ejection fraction <50% (end-stage HC) and 11 (5%) developed an apical aneurysm. Follow-up length (odds ratio 1.07, 95% confidence interval 1.00 to 1.15, p = 0.06) and maximal LV wall thickness at baseline (odds ratio 1.14, 95% confidence interval 1.04 to 1.25, p = 0.004) were the main predictors of MWT thinning. Compared with patients with end-stage HC and apical aneurysm, those with MWT thinning showed lower HC-related morbidity (92% and 36% vs 22%, p = 0.003) and mortality (31% and 27% vs 4%, p = 0.02). Furthermore, they showed a combined HC-related morbidity and mortality similar to patients without LV remodeling (incidence 29/1000 vs 26/1000 patient-year, p = 0.77). In conclusion, a process of LV wall thinning with a benign outcome can occur over the long term in patients with HC. The prognostic importance of LV remodeling varies in relation to the different changes in LV morphology and function.

Original languageEnglish
Pages (from-to)1924-1931
Number of pages8
JournalThe American Journal of Cardiology
Volume122
Issue number11
DOIs
Publication statusPublished - Dec 1 2018

Fingerprint

Ventricular Remodeling
Hypertrophic Cardiomyopathy
Aneurysm
Odds Ratio
Confidence Intervals
Morbidity
Mortality
Left Ventricular Function
Stroke Volume
Incidence

Cite this

Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy. / Musumeci, Maria Beatrice; Russo, Domitilla; Limite, Luca Rosario; Canepa, Marco; Tini, Giacomo; Casenghi, Matteo; Francia, Pietro; Adduci, Carmen; Pagannone, Erika; Magrì, Damiano; Volpe, Massimo; Autore, Camillo.

In: The American Journal of Cardiology, Vol. 122, No. 11, 01.12.2018, p. 1924-1931.

Research output: Contribution to journalArticle

Musumeci, MB, Russo, D, Limite, LR, Canepa, M, Tini, G, Casenghi, M, Francia, P, Adduci, C, Pagannone, E, Magrì, D, Volpe, M & Autore, C 2018, 'Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy', The American Journal of Cardiology, vol. 122, no. 11, pp. 1924-1931. https://doi.org/10.1016/j.amjcard.2018.08.041
Musumeci, Maria Beatrice ; Russo, Domitilla ; Limite, Luca Rosario ; Canepa, Marco ; Tini, Giacomo ; Casenghi, Matteo ; Francia, Pietro ; Adduci, Carmen ; Pagannone, Erika ; Magrì, Damiano ; Volpe, Massimo ; Autore, Camillo. / Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy. In: The American Journal of Cardiology. 2018 ; Vol. 122, No. 11. pp. 1924-1931.
@article{e011118a7b944a22ba49b6764cffe744,
title = "Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy",
abstract = "In hypertrophic cardiomyopathy (HC), a process of left ventricular (LV) remodeling carrying an adverse prognosis has been described. Conversely, a gradual and benign LV wall thinning has been suggested but never investigated. Therefore, we studied a HC cohort over a long period of time to evaluate the occurrence of a LV remodeling with a benign clinical course. Data of HC patients aged 18 to 65 years and without any condition known to influence LV remodeling were analyzed over a mean follow-up of 7.6 ± 5.7 years. Of 231 HC patients (65{\%} males, mean age 46 ± 12 years), 47 (20{\%}) developed LV remodeling, of whom 23 (10{\%}) had a thinning ≥15{\%} of LV maximal wall thickness from baseline without systolic dysfunction (MWT thinning); 13 (6{\%}) progressed to a LV ejection fraction <50{\%} (end-stage HC) and 11 (5{\%}) developed an apical aneurysm. Follow-up length (odds ratio 1.07, 95{\%} confidence interval 1.00 to 1.15, p = 0.06) and maximal LV wall thickness at baseline (odds ratio 1.14, 95{\%} confidence interval 1.04 to 1.25, p = 0.004) were the main predictors of MWT thinning. Compared with patients with end-stage HC and apical aneurysm, those with MWT thinning showed lower HC-related morbidity (92{\%} and 36{\%} vs 22{\%}, p = 0.003) and mortality (31{\%} and 27{\%} vs 4{\%}, p = 0.02). Furthermore, they showed a combined HC-related morbidity and mortality similar to patients without LV remodeling (incidence 29/1000 vs 26/1000 patient-year, p = 0.77). In conclusion, a process of LV wall thinning with a benign outcome can occur over the long term in patients with HC. The prognostic importance of LV remodeling varies in relation to the different changes in LV morphology and function.",
author = "Musumeci, {Maria Beatrice} and Domitilla Russo and Limite, {Luca Rosario} and Marco Canepa and Giacomo Tini and Matteo Casenghi and Pietro Francia and Carmen Adduci and Erika Pagannone and Damiano Magr{\`i} and Massimo Volpe and Camillo Autore",
note = "Copyright {\circledC} 2018. Published by Elsevier Inc.",
year = "2018",
month = "12",
day = "1",
doi = "10.1016/j.amjcard.2018.08.041",
language = "English",
volume = "122",
pages = "1924--1931",
journal = "American Journal of Cardiology",
issn = "0002-9149",
publisher = "Elsevier Inc.",
number = "11",

}

TY - JOUR

T1 - Long-Term Left Ventricular Remodeling of Patients With Hypertrophic Cardiomyopathy

AU - Musumeci, Maria Beatrice

AU - Russo, Domitilla

AU - Limite, Luca Rosario

AU - Canepa, Marco

AU - Tini, Giacomo

AU - Casenghi, Matteo

AU - Francia, Pietro

AU - Adduci, Carmen

AU - Pagannone, Erika

AU - Magrì, Damiano

AU - Volpe, Massimo

AU - Autore, Camillo

N1 - Copyright © 2018. Published by Elsevier Inc.

PY - 2018/12/1

Y1 - 2018/12/1

N2 - In hypertrophic cardiomyopathy (HC), a process of left ventricular (LV) remodeling carrying an adverse prognosis has been described. Conversely, a gradual and benign LV wall thinning has been suggested but never investigated. Therefore, we studied a HC cohort over a long period of time to evaluate the occurrence of a LV remodeling with a benign clinical course. Data of HC patients aged 18 to 65 years and without any condition known to influence LV remodeling were analyzed over a mean follow-up of 7.6 ± 5.7 years. Of 231 HC patients (65% males, mean age 46 ± 12 years), 47 (20%) developed LV remodeling, of whom 23 (10%) had a thinning ≥15% of LV maximal wall thickness from baseline without systolic dysfunction (MWT thinning); 13 (6%) progressed to a LV ejection fraction <50% (end-stage HC) and 11 (5%) developed an apical aneurysm. Follow-up length (odds ratio 1.07, 95% confidence interval 1.00 to 1.15, p = 0.06) and maximal LV wall thickness at baseline (odds ratio 1.14, 95% confidence interval 1.04 to 1.25, p = 0.004) were the main predictors of MWT thinning. Compared with patients with end-stage HC and apical aneurysm, those with MWT thinning showed lower HC-related morbidity (92% and 36% vs 22%, p = 0.003) and mortality (31% and 27% vs 4%, p = 0.02). Furthermore, they showed a combined HC-related morbidity and mortality similar to patients without LV remodeling (incidence 29/1000 vs 26/1000 patient-year, p = 0.77). In conclusion, a process of LV wall thinning with a benign outcome can occur over the long term in patients with HC. The prognostic importance of LV remodeling varies in relation to the different changes in LV morphology and function.

AB - In hypertrophic cardiomyopathy (HC), a process of left ventricular (LV) remodeling carrying an adverse prognosis has been described. Conversely, a gradual and benign LV wall thinning has been suggested but never investigated. Therefore, we studied a HC cohort over a long period of time to evaluate the occurrence of a LV remodeling with a benign clinical course. Data of HC patients aged 18 to 65 years and without any condition known to influence LV remodeling were analyzed over a mean follow-up of 7.6 ± 5.7 years. Of 231 HC patients (65% males, mean age 46 ± 12 years), 47 (20%) developed LV remodeling, of whom 23 (10%) had a thinning ≥15% of LV maximal wall thickness from baseline without systolic dysfunction (MWT thinning); 13 (6%) progressed to a LV ejection fraction <50% (end-stage HC) and 11 (5%) developed an apical aneurysm. Follow-up length (odds ratio 1.07, 95% confidence interval 1.00 to 1.15, p = 0.06) and maximal LV wall thickness at baseline (odds ratio 1.14, 95% confidence interval 1.04 to 1.25, p = 0.004) were the main predictors of MWT thinning. Compared with patients with end-stage HC and apical aneurysm, those with MWT thinning showed lower HC-related morbidity (92% and 36% vs 22%, p = 0.003) and mortality (31% and 27% vs 4%, p = 0.02). Furthermore, they showed a combined HC-related morbidity and mortality similar to patients without LV remodeling (incidence 29/1000 vs 26/1000 patient-year, p = 0.77). In conclusion, a process of LV wall thinning with a benign outcome can occur over the long term in patients with HC. The prognostic importance of LV remodeling varies in relation to the different changes in LV morphology and function.

U2 - 10.1016/j.amjcard.2018.08.041

DO - 10.1016/j.amjcard.2018.08.041

M3 - Article

C2 - 30293658

VL - 122

SP - 1924

EP - 1931

JO - American Journal of Cardiology

JF - American Journal of Cardiology

SN - 0002-9149

IS - 11

ER -