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Long-term outcome of nonobstructive versus obstructive hypertrophic cardiomyopathy: A systematic review and meta-analysis
Abstract
Background Prognosis of hypertrophic cardiomyopathy (HCM) is particularly heterogeneous. Patients with nonobstructive HCM (NOCM) are thought to be at relatively low-risk as compared with obstructive HCM (HOCM) with no need of major treatment options. However, available evidence of NOCM comes mainly from tertiary centers where a referral bias is likely to occur. Aim of this study was to perform a systematic review and meta-analysis of the published literature on hypertrophic cardiomyopathy (HCM) in order to outline differences in presenting features and long-term outcome between NOCM and HOCM. Methods MEDLINE/Pubmed, EMBASE and Cochrane databases up to December 31, 2016, and reviewed cited references to identify relevant studies were used. The primary endpoints were HCM-related overall mortality rate and yearly rate of cardiac death. Other endpoints were incidences of sudden and congestive heart failure deaths. Results A total of 20 studies entered the meta-analysis on the long-term outcome of NOCM vs HOCM. They included a total of 7731 patients, 5058 patients with NOCM (65%) and 2673 patients with HOCM (35%). During the follow-up, annual mortality related to HCM averaged 1.55% in NOCM and 1.77% in HOCM (Relative Risk: 0.89, 95% confidence intervals: 0.68 to 1.17, p=0.40). Overall, 5 studies reported significantly higher mortality for HOCM, 3 higher mortality for NOCM, and 12 no significant differences. Conclusion This large study-level meta-analysis shows that long-term morta…
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“Many patients with non-obstructive hypertrophic cardiomyopathy have symptoms, with 8% in New York Heart Association (NYHA) class III or IV, and mortality rates are similar to those of patients with obstructive hypertrophic cardiomyopathy.40”
From Current management of hypertrophic cardiomyopathy (2025) · cites this paper as [40]
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Ommen, S. R., Ho, C. Y., Asif, I. M., Balaji, S., Burke, M. A., Day, S. M., Dearani, J. A., Epps, K. C., Evanovich, L., Ferrari, V. A., et al. (2024) · Circulation · doi:10.1161/cir.0000000000001250 · Cited by 807
Current management of hypertrophic cardiomyopathy
Sikand, N., Stendahl, J., Sen, S., Lampert, R., & Day, S. (2025) · BMJ · doi:10.1136/bmj-2023-077274 · Cited by 26
Metadata
- Authors
- Pelliccia, F., Pasceri, V., Limongelli, G., Autore, C., Basso, C., Corrado, D., Imazio, M., Rapezzi, C., Sinagra, G., & Mercuro, G.
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2017-09
- Volume
- 243
- Pages
- 379-384
- ISSN
- 0167-5273
- Cited by
- 66
- References
- 2
- Language
- en
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- Pelliccia, F., Pasceri, V., Limongelli, G., Autore, C., Basso, C., Corrado, D., Imazio, M., Rapezzi, C., Sinagra, G., & Mercuro, G. (2017). Long-term outcome of nonobstructive versus obstructive hypertrophic cardiomyopathy: A systematic review and meta-analysis. International Journal of Cardiology. https://doi.org/10.1016/j.ijcard.2017.06.071