CardiomyopathyIndependent Assessment of the European Society of Cardiology Sudden Death Risk Model for Hypertrophic Cardiomyopathy
Section snippets
Methods
Case records of the Hypertrophic Cardiomyopathy Centers of the Minneapolis Heart Institute Foundation and Tufts Medical Center were accessed, and 1,629 consecutively evaluated and prospectively followed patients with HC aged ≥16 years at the first evaluation (October 1992 to May 2014) were identified, with a total follow-up period of 13,274 patient-years, to November 2014. This project was reviewed and approved by the institutional review boards at each center.
The study population of 1,629
Results
Of the 1,629 total study patients, at initial evaluation, 901 (55%) were asymptomatic (New York Heart Association class I), 443 (27%) were mildly symptomatic (class II), and 285 (17%) were severely symptomatic (classes III/IV); 1,067 (66%) patients were men. Echocardiographic measurements were: maximum LV wall thickness (usually ventricular septum), 21 ± 6 mm with 135 patients (8%) ≥30 mm; LV end-diastolic dimension, 34 ± 5 mm; left atrial dimension, 42 ± 8 mm; ejection fraction, 64 ± 7%.
In 35
Discussion
With the ICD widely available to patients with HC over the past 15 years, the principle of SD prevention has become a reality.1, 2, 3, 9, 10, 11, 12, 13, 14, 15, 17 The risk stratification algorithm in general usage, based on retrospective cohort analyses, has been highly effective for identifying many patients with HC who will benefit from ICD therapy, instrumental in decreasing SD rate1, 9, 10, 11, 13, 28 and HC-related mortality to 0.5%/year.28
It is also apparent that the current risk
Disclosures
The authors have no conflicts of interest to disclose.
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