Different clinical characteristics and outcomes of hypertrophic cardiomyopathy with and without hypertension: seeking the truth
Yu ZHANG1
Ming-Hao LIU2
Mo ZHANG2
Gui-Xin WU3
Jie LIU1
Ji-Zheng WANG1
Xiao-Lu SUN2
Wen JIANG2
Dong WANG2
Lian-Ming KANG2
Xue-Yi WU2
Yu-Bao ZOU4
Lei SONG5
1.State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China2.Cardiomyopathy Ward,Fuwai Hosp-ital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical Coll-ege,Beijing,China3.State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China;Cardiomyopathy Ward,Fuwai Hosp-ital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical Coll-ege,Beijing,China4.Department of Cardiology,Fuwai Hospital,National Center for Cardiovascular Disease,Chinese Ac-ademy of Medical Sciences and Peking Union Medical College,Beijing,China5.State Key Laboratory of Cardiovascular Disease,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China;Cardiomyopathy Ward,Fuwai Hosp-ital,National Center for Cardiovascular Disease,Chinese Academy of Medical Sciences and Peking Union Medical Coll-ege,Beijing,China;National Clinical Research Center of Ca-rdiovascular Diseases,Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Scie-nces and Peking Union Medical College,Beijing,China
摘要：OBJECTIVE To determine the different clinical characteristics and outcomes of hypertrophic cardiomyopathy (HCM) patients with and without hypertension (HT). METHODS A total of 696 HCM patients were included in this study and all HCM diagnoses were confirmed by the genetic test. Patients were analyzed separately in the septal reduction therapy (SRT) cohort and the non-SRT cohort. The primary endpoint was cardiovascular death and the secondary endpoint was all-cause death. Outcome analyses were conducted to evaluate the associati-ons between HT and outcomes in HCM. Medications before enrollment and at discharge were collected in the post-hoc analyses. RESULTS HCM patients without HT were younger, had a lower body mass index, were more likely to have a family history of HCM, and had a smaller left ventricular (LV) end-diastolic diameter than those with HT in both cohorts. A thicker LV wall, a hig-her level of N-terminal pro-B-type natriuretic peptide, and a higher extent of LV late gadolinium enhancement were additionally observed in patients without HT in the non-SRT cohort. The presence of HT did not alter the distribution pattern of late gadolinium enhancement, as well as the constituent ratio of eight disease-causing sarcomeric gene variants in both cohorts. Outcome analyses sh-owed that in the non-SRT cohort, patients without HT had higher risks of cardiovascular death (HR = 2.537, P = 0.032) and all-cause death (HR = 3.309, P = 0.032). While such prognostic divergence was not observed in the SRT cohort. Further post-hoc analyses in the non-SRT cohort found that patients without HT received fewer non-dihydropyridine calcium channel blockers and angiotensin-converting enzyme inhibitors/angiotensin receptor blockers before enrollment and at discharge. CONCLUSIONS HCM patients without HT had worse clinical conditions and higher mortality than patients with HT overall, which may result from active medical therapy in HT patients. Active SRT may have a substantial de-risking effect on patients meet-ing the indications.
机标关键词：hypertensioncharacteristicsdifferentclinicalcardiomyopathyhypertrophicoutcomesseeking
论文发表日期：2023-02-28
在线出版日期：2025-08-15（本平台首次上网日期，不代表文献的发表时间）
页数：12( 109-120 )