Prognostic determinants in hypertrophic cardiomyopathy. Prospective evaluation of a therapeutic strategy based on clinical, Holter, hemodynamic, and electrophysiological findings.
- 1 September 1992
- journal article
- abstracts
- Published by Wolters Kluwer Health in Circulation
- Vol. 86 (3), 730-740
- https://doi.org/10.1161/01.cir.86.3.730
Abstract
BACKGROUNDPatients with hypertrophic cardiomyopathy (HCM) frequently have arrhythmias and hemodynamic abnormalities and are prone to sudden death and syncope. An important need exists for improved risk stratification and definition of appropriate investigation and therapy.METHODS AND RESULTSThe relation of 31 clinical, Holter, cardiac catheterization, and electrophysiological (EP) variables to subsequent cardiac events in 230 HCM patients was examined by multivariate analysis. Studies were for cardiac arrest (n = 32), syncope (n = 80), presyncope (n = 52), ventricular tachycardia (VT) on Holter (n = 36), a strong family history of sudden death (n = 9), and palpitations (n = 21). Nonsustained VT on Holter was present in 115 patients (50%). Sustained ventricular arrhythmia was induced in 82 patients (36%). Seventeen cardiac events (eight sudden deaths, one cardiac arrest, and eight syncope with defibrillator discharges) occurred during a follow-up of 28 +/- 19 months. The 1-year and 5-year event-free rates ...Keywords
This publication has 30 references indexed in Scilit:
- Hypertrophic Cardiomyopathy and Sudden DeathNew England Journal of Medicine, 1988
- Sustained Arrhythmias in Hypertrophic Obstructive CardiomyopathyNew England Journal of Medicine, 1984
- Potentially lethal arrhythmias and their management in hypertrophic cardiomyopathyThe American Journal of Cardiology, 1984
- Prognosis in hypertrophic cardiomyopathy: Role of age and clinical, electrocardiographic and hemodynamic featuresThe American Journal of Cardiology, 1981
- Rhythm disturbances in hypertrophic cardiomyopathy: Prevalence, relation to symptoms and managementThe American Journal of Cardiology, 1980
- Arrhythmia in hypertrophic cardiomyopathy: Exercise and 48 hour ambulatory electrocardiographic assessment with and without beta adrenergic blocking therapyThe American Journal of Cardiology, 1980
- Idiopathic hypertrophic subaortic stenosis in the youngThe American Journal of Cardiology, 1978
- “Malignant” hypertrophic cardiomyopathy: Identification of a subgroup of families with unusually frequent premature deathThe American Journal of Cardiology, 1978
- Electrophysiologic findings in patients with idiopathic hypertrophic subaortic stenosisThe American Journal of Cardiology, 1978
- Complete heart block as a cause of syncope in asymmetric septal hypertrophyAmerican Heart Journal, 1977