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Cited by 410Cardiomyopathy and Myosin StudiesViral Infections and Immunology ResearchBlood Pressure and Hypertension Studies

Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy

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Sherrid, Mark V., Barac, Ivan, McKenna, William J., Elliott, Perry M., Dickie, Shaughan, Chojnowska, Lidia, Casey, Susan, Maron, Barry J.·2005·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2005.01.012
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Abstract

Objectives In this study we assessed the long-term efficacy and safety of disopyramide for patients with obstructive hypertrophic cardiomyopathy (HCM).Background It has been reported that disopyramide may reduce left ventricular outflow gradient and improve symptoms in patients with HCM. However, long-term efficacy and safety of disopyramide has not been shown in a large cohort.Methods Clinical and echocardiographic data were evaluated in 118 obstructive HCM patients treated with disopyramide at 4 HCM treatment centers. Mortality in the disopyramide-treated patients was compared with 373 obstructive HCM patients not treated with disopyramide.Results Patients were followed with disopyramide for 3.1 +/- 2.6 years; dose 432 +/- 181 mg/day (97% also received beta-blockers). Seventy-eight patients (66%) were maintained with disopyramide without the necessity for major non-pharmacologic intervention with surgical myectomy, alcohol ablation, or pacing; outflow gradient at rest decreased from 75 +/- 33 to 40 +/- 32 mm Hg (p < 0.0001) and mean New York Heart Association functional class from 2.3 +/- 0.7 to 1.7 +/- 0.6 (p < 0.0001). Forty other patients (34%) could not be satisfactorily managed with disopyramide and required major invasive interventions because of inadequate symptom and gradient control or vagolytic side effects. All-cause annual cardiac death rate between disopyramide and non-disopyramide-treated patients did not differ significantly, 1.4% versus 2.6%/year (p = 0.07). There was also no difference in sudden death rate, 1.0%/year versus 1.8%/year (p = 0.08).Conclusions Two-thirds of obstructed HCM patients treated with disopyramide could be managed medically with amelioration of symptoms and about 50% reduction in subaortic gradient over >/=3 years. Disopyramide therapy does not appear to be proarrhythmic in HCM and should be considered before proceeding to surgical myectomy or alternate strategies.

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Authors
Sherrid, M. V., Barac, I., McKenna, W. J., Elliott, P. M., Dickie, S., Chojnowska, L., Casey, S., & Maron, B. J.
Affiliations
  • St. Luke's-Roosevelt Hospital Center (US)
  • St George's, University of London (GB)
  • Institute of Cardiology (PL)
  • Minneapolis Heart Institute Foundation (US)
Corresponding author
Sherrid, Mark V.
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2005-04
Volume
45
Issue
8
Pages
1251-1258
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2005.01.012
OpenAlex
W1992100033
Cited by
410
References
52
Citations by year
2026: 12 · 2025: 35 · 2024: 34 · 2023: 24 · 2022: 23 · 2021: 23 · 2020: 20 · 2019: 14 · 2018: 19 · 2017: 16 · 2016: 15 · 2015: 17 · 2014: 27 · 2013: 18 · 2012: 22
FWCI
8.45
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • UCL Discovery (University College London) (submittedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Viral Infections and Immunology Research
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Blood Pressure and Hypertension Studies
Keywords
disopyramide, hypertrophic obstructive cardiomyopathy, left ventricular outflow tract gradient, long-term efficacy, drug safety, sudden cardiac death, cardiac mortality, drug-induced arrhythmia, beta-blockers, myectomy, alcohol septal ablation, NYHA functional class
MeSH terms
Administration, Oral, Adrenergic beta-Antagonists, Anti-Arrhythmia Agents, Cardiomyopathy, Hypertrophic, Disopyramide, Echocardiography, Female, Humans, Male, Middle Aged, Myocardial Contraction, Safety, Death, Sudden, Cardiac, Treatment Outcome

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