Cardiology Letters 2024, 33(3):168-174

Hypertrophic cardiomyopathy in a tertiary care centre - a descriptive analysis

Marcela Danková¹, Veronika Šimovičová¹, Stanislav Mizera², Miriam Vojvodová¹, Eva Gonçalvesová¹

¹ Kardiologická klinika Lekárská Fakulty UK a Národný ústav srdcových a cievnych chorôb, a. s., Bratislava

² Oddelenie Intervenčnej kardiológie Národný ústav srdcových a cievnych chorôb, a. s., Bratislava, Slovenská republika

Background: Hypertrophic cardiomyopathy (HCM) is a heterogeneous disease with variable phenotypic expression. There has been a significant advancement in the diagnosis, treatment and influencing of the prognosis of patients in recent years.

Aim: To describe the characteristics of the patients with sarcomeric hypertrophic cardiomyopathy hospitalized in a tertiary care centre and to evaluate diagnostic and therapeutic interventions in this group of patients.

Patients and methods: We retrospectively analyzed data from the Hospital Information System from January 1, 2013 to April 27, 2023. The study included 213 patients who met the criteria for the definition of hypertrophic cardiomyopathy. There were 145 (68.1%) patients with the obstructive form (HOCM) and 68 (31.9%) patients without obstruction.

Results: The median age was 55 years (IQR 43-64), with a gender distribution of 108/105 (male/ female). There were a total of 184 patients (86.4%) in the NYHA functional class II-IV. Cardiac magnetic resonance was performed in almost 30% of all patients. The percentage of patients who underwent genetic analysis was 15%. Betablockers were the most frequently indicated drug group (63.8% in total). Septal reduction therapies were performed in 8.5% of patients. Heart transplantation was performed in 15 patients (7%), dominantly in the non-obstructive group (17.6 vs 2.1%, p <.0001). We observed worse survival rate in the non-obstructive versus obstructive group (p=0.04).

Conclusion: Based on this analysis, specialized care is required almost exclusively in symptomatic patients, despite the fact that most patients with HCM are asymptomatic and the disease is associated with a risk of sudden cardiac death. The availability/implementation of cardiac magnetic resonance, as well as genetic examination and counseling does not correspond to current recommendations. Patients with a non-obstructive form of HCM had a worse prognosis. Examinations focused on the presence of a specific myocardial hypertrophy etiology is not a standard diagnostic process. Availability of septal reduction therapy is good.

Keywords: hypertrophic cardiomyopathy; tertiary centre; diagnosis; treatment; prognosis

Published: March 1, 2024  Show citation