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Progressive left ventricular remodeling in patients with hypertrophic cardiomyopathy and severe left ventricular hypertrophy

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dc.contributor.authorThaman, Rajesh
dc.contributor.authorGimeno Blanes, Juan Ramón
dc.contributor.authorReith, Sebastian
dc.contributor.authorTome Esteban, María T.
dc.contributor.authorLimongelli, Giuseppe
dc.contributor.authorMurphy, Ross T.
dc.contributor.authorMist, Bryan
dc.contributor.authorMcKenna, William J.
dc.contributor.authorElliot, Perry M.
dc.contributor.departmentMedicina
dc.contributor.otherFacultades de la UMU::Facultad de Medicina
dc.date.accessioned2026-01-13T08:10:09Z
dc.date.available2026-01-13T08:10:09Z
dc.date.copyright© 2004 American College of Cardiology Foundation.
dc.date.issued2004-01-27
dc.description.abstractObjectives The aim of this study was to determine the natural history of patients with hypertrophic cardiomyopathy (HCM) and severe left ventricular hypertrophy (LVH) (i.e., maximal left ventricular wall thickness [MLVWT] ≥30 mm) and whether changes in cardiac morphology influence the course of the disease. Background Severe LVH is common in young and rare among elderly patients with HCM. This has been explained by a high incidence of sudden death. We hypothesized that this age-related difference might be explained by left ventricular wall thinning. Methods A total of 106 (age 33 ± 15 years; 71 males) consecutive patients with severe LVH underwent history taking, examination, electrocardiography, echocardiography, cardiopulmonary exercise testing, and Holter analysis. Survival data were collected at subsequent clinic visits or by communication with patients and their general practioners. In order to assess morphologic and functional changes, 71 (67.0%) patients (mean age 31 ± 15 years; 47 males) followed at our institution underwent serial (≥1 year) assessment. Results Of the 106 patients, the majority (78 [71.6%]) were <40 years of age. During follow-up (92 ± 50 months [range 1 to 169]), 18 (17.0%) patients died or underwent heart transplantation (13 sudden cardiac deaths, 2 heart failure deaths, 1 heart transplantation, 1 stroke, 1 postoperative death). Five-year survival from sudden death was 90.1% (95% confidence interval [CI] 84.0% to 96.3%), and that from heart failure death or transplantation was 97.7% (95% CI 94.5 to 100). In patients serially evaluated over 85 ± 51 months, there was an overall reduction in MLVWT of 0.6 mm/year (95% CI 0.31 to 0.81, p = 0.00004). Wall thinning ≥5 mm was observed in 41 patients (57.7%; age 35 ± 13 years; 28 males). On multivariate analysis, the follow-up duration only predicted wall thinning (0.6 mm/year, 95% CI 0.38 to 0.85, p < 0.00001). Conclusions Left ventricular remodeling is common in patients with severe LVH and contributes to the low prevalence of severe LVH seen in middle age and beyond.
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dc.identifier.citationJournal of the American College of Cardiology, 2004, Vol. 44, Issue 2, pp. 398-405
dc.identifier.doihttps://doi.org/10.1016/j.jacc.2004.01.054
dc.identifier.eissn1558-3597
dc.identifier.issn0735-1097
dc.identifier.urihttp://hdl.handle.net/10201/186049
dc.languageeng
dc.publisherElsevier
dc.relationSin financiación externa a la Universidad
dc.relation.publisherversionhttps://www.sciencedirect.com/science/article/pii/S0735109704008435
dc.rights.accessRightsinfo:eu-repo/semantics/restrictedAccess
dc.subject.odsNo relacionado con ningún objetivo de desarrollo sostenible
dc.titleProgressive left ventricular remodeling in patients with hypertrophic cardiomyopathy and severe left ventricular hypertrophy
dc.typeinfo:eu-repo/semantics/article
dc.type.versioninfo:eu-repo/semantics/publishedVersion
dspace.entity.typePublicationes
relation.isAuthorOfPublication4d37f6b7-66c0-4f9a-81c7-72d9bd67f2fb
relation.isAuthorOfPublication.latestForDiscovery4d37f6b7-66c0-4f9a-81c7-72d9bd67f2fb
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