Open AccessClinical characteristics and outcomes of hypertrophic cardiomyopathy in Taiwan—a tertiary center experience
Author(s) -
Lee ChengHan,
Liu PingYen,
Lin LiJen,
Chen JyhHong,
Tsai LiangMiin
Publication year - 2007
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.20057
Subject(s) - medicine , hypertrophic cardiomyopathy , cardiology , atrial fibrillation , cardiomyopathy , odds ratio , left ventricular hypertrophy , left atrial enlargement , concentric hypertrophy , diastole , heart failure , sinus rhythm , blood pressure
Background Most information concerning hypertrophic cardiomyopathy has been derived from western countries and Japan. Hypothesis Patients with hypertrophic cardiomyopathy in Taiwan may have a distinct morphology and clinical picture. Methods Information from 163 consecutive patients with hypertrophic cardiomyopathy at a medical center in Taiwan from 1990 through 2005 was retrospectively collected. The diagnosis of hypertrophic cardiomyopathy required echocardiographic demonstration of left ventricular hypertrophy (wall thickness ≥ mm during diastole) in a specific region or with diffuse distribution. Follow‐up information was obtained from medical records. Results Among 163 patients (male, 52%), the mean follow‐up period was 5.3 ± 4.1 years. Men had nearly a threefold increase in prevalence of apical hypertrophic cardiomyopathy (23.8% vs. 8.9%, p = 0.03), younger onset of initial evaluation (57.2 ± 12.9 vs. 64.8 ± 11.3, p < 0.001), and lower prevalence of hypertrophic obstructive cardiomyopathy (33.3% vs. 63.3%, p < 0.001) compared to women. Fifty‐eight patients (35.6%) experienced cardiovascular events, of which pulmonary edema and paroxysmal atrial fibrillation were the most common (19.7% and 12.3%, respectively). The annual cardiovascular mortality rate was 0.8%. In multivariate analysis, left ventricular outflow obstruction [odds ratio (OR): 4.92, p = 0.001], atrial fibrillation (OR: 3.53, p = 0.014), and female gender (OR: 2.99, p = 0.043) were independent predictors of mortality. Conclusions Hypertrophic cardiomyopathy did not significantly increase cardiovascular mortality rate, but over one‐third of patients with hypertrophic cardiomyopathy experienced cardiovascular events. High prevalence of left ventricular outflow obstruction especially in elderly women was observed. Left ventricular outflow obstruction, atrial fibrillation, and female gender were predictors of mortality. Copyright © 2007 Wiley Periodicals, Inc.