Symptom assessment and exercise impairment in surgical decision making in hypertrophic obstructive cardiomyopathy: Relationship to outcomes

The Journal of Thoracic and Cardiovascular Surgery
Milind Y DesaiHarry M Lever

Abstract

We sought to assess the long-term outcomes in patients with hypertrophic cardiomyopathy and severe left ventricular outflow tract obstruction, in whom the decision regarding surgery (vs conservative management) was based on assessment of symptoms or exercise capacity. This was an observational study of 1530 patients with hypertrophic cardiomyopathy (aged 50 ± 13 years, 63% were men) with severe left ventricular outflow tract obstruction (excluding those aged <18 years, with left ventricular ejection fraction <50%, and with left ventricular outflow tract gradient <30 mm Hg). A composite end point of death (excluding noncardiac causes) and/or implantable defibrillator discharge was assessed. Coronary artery disease, family history of hypertrophic cardiomyopathy, and syncope were present in 15%, 17%, and 18% of patients, respectively, whereas 73% patients were in New York Heart Association class II or greater. Mean left ventricular ejection fraction, basal septal thickness, and left ventricular outflow tract gradient (resting or provocable) were 62% ± 5%, 2.2 ± 1 cm, and 101 ± 39 mm Hg, respectively. A total of 858 patients (56%) underwent exercise echocardiography, of whom 503 (59%) had exercise capacity impairment. At 8.1 ± 6 ye...Continue Reading

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Citations

Jan 31, 2016·The Journal of Thoracic and Cardiovascular Surgery·Ahmad MasriMilind Y Desai
Oct 21, 2015·The Journal of Thoracic and Cardiovascular Surgery·Rick A Nishimura, Hartzell V Schaff
Mar 12, 2016·JACC. Cardiovascular Interventions·Mackram F Eleid, Rick A Nishimura
Oct 2, 2015·The Journal of Thoracic and Cardiovascular Surgery·Steve R Ommen, Joseph A Dearani
Oct 1, 2016·Journal of the American College of Cardiology·Adaya Weissler-SnirHarry Rakowski
Mar 8, 2017·The Journal of Thoracic and Cardiovascular Surgery·Barry J MaronHartzell V Schaff
Feb 14, 2018·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Carlos A MestresEduard Quintana
Sep 16, 2017·Circulation Research·Rick A NishimuraHartzell V Schaff
Nov 29, 2017·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Anita NguyenSteve R Ommen
Feb 18, 2020·Circulation. Cardiovascular Imaging·Albree Tower-RaderMilind Y Desai
Mar 19, 2020·Herz·Angelika Batzner, Hubert Seggewiß
Mar 12, 2019·Deutsches Ärzteblatt International·Angelika BatznerHubert Seggewiß
Aug 18, 2018·Journal of the American College of Cardiology·Amgad MentiasMilind Y Desai

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