PROGNOSTIC DETERMINANTS OF HYPERTROPHIC CARDIOMYOPATHY - THE RESULTS OF THE SHIGA CARDIOMYOPATHY STUDY

Previous studies have reported that patients with hypertrophic cardiom yopathy (HCM) are prone to sudden death. In this study, we retrospecti vely assessed the prognosis and any influencing factors in 83 patients (66 male, 17 female) with HCM. Twenty-two patients were obstructive, 40 were non-obstructive, 18 were apical HCM and 3 were unclassified. F our of the 83 cases progressed to left ventricular dilatation and dysf unction during the follow-up period. The mean age was 51.2 years (rang e 16 to 73) and the mean duration of follow-up was 6.7 years (range 0. 3 to 15.1). The 5- and 10-year survival rates were 98% and 89%, respec tively. Five patients died; 3 from cardiac events (two sudden deaths a nd one due to congestive heart failure) and 2 from malignant diseases. The lack of a family history of sudden death and the amplitude of the S wave in lead V-1 (less than 2.0 mV) were associated with a favorabl e prognosis. None of the patients who were diagnosed before age 50 die d, but this observation was not statistically significant. None of the patients with apical HCM died, but the classification of HCM was not significantly associated with the prognosis. None of the patients with out medication died and medical treatment did not influence the progno sis. Sex, family history of HCM, the patient's symptoms and physical s igns, NYHA classification of cardiovascular disability, thickness of t he septum and the posterior wall of the left ventricle, dimension of t he left atrium, and the left and right ventricles in echocardiogram, a mplitude of the R wave in lead V-5, the depth of the negative T wave a nd atrial fibrillation did not influence the prognosis.