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Retrospective analysis of clinical phenotype and prognosis of hypertrophic cardiomyopathy complicated with hypertension

Luo, Qin, Chen, Jin, Zhang, Tianhua, Tang, Xiaoyu, Yu, Bilian·2020·Scientific Reports
DOI 10.1038/s41598-019-57230-zPMC PMC6962215
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Abstract

We here studied the clinical features, cardiac structure, and functional changes and prognosis of hypertrophic cardiomyopathy (HCM) patients with hypertension (HTN). A total of 90 HCM patients with HTN and 172 patients without HTN were divided into a hypertensive group and non-hypertensive group. The clinical characteristics, cardiac structure and function, and prognosis of the two groups were compared. Our study found that HCM patients with HTN had fewer syncope events in their medical histories (8% vs. 22%, P < 0.01) and sudden deaths in the family (3% vs. 10%, P < 0.05). The prevalence of apical hypertrophy (18% vs. 7%, P < 0.01) and midventricular obstruction (26% vs. 15%, P < 0.05) was higher in the HTN group. Besides, simple HCM patients had more pathogenic gene mutations, while those with HTN were more likely to have mutations of uncertain clinical significance (64% vs. 24%, P < 0.05). Evaluation of 5-year survival rate showed a trend for a worse prognosis in HCM patients with HTN, but the results were not statistically insignificant (P = 0.065). In conclusion, we found that the clinical phenotypes of HCM patients with HTN differed from those of patients with HCM alone, suggesting that HTN may play a pathogenic role in the pathogenesis of hypertensive hypertrophic cardiomyopathy patients.

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  • There is no difference in the presence of left ventricular outflow tract obstruction between HOCM patients with and without hypertension, but the prevalence of left ventricular outflow tract obstruction is significantly higher in patients with hypertension.

    “Previous studies have shown no difference in the presence of LVOT obstruction between HOCM patients with and without hypertension, but the prevalence of LVOT obstruction was significantly higher in patients with hypertension (10),(11).”

    From Management of Hypertrophic Obstructive Cardiomyopathy with Concurrent Hypertension and Intracerebral Haemorrhage: A Case Report (2024) · cites this paper as [10]

  • Patients with HOCM and a history of hypertension had fewer syncopal episodes and a lower prevalence of sudden cardiac death in the family compared with those with HOCM without hypertension.

    “In a study by Luo Q et al., it was concluded that patients with HOCM and a history of hypertension had fewer syncopal episodes and a lower prevalence of sudden cardiac death in the family compared to those with HOCM without hypertension.”

    From Management of Hypertrophic Obstructive Cardiomyopathy with Concurrent Hypertension and Intracerebral Haemorrhage: A Case Report (2024) · cites this paper as [10]

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Citations

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Research works printed but not linked: 19

  1. Varma, P. K. & Neema, P. K. Hypertrophic cardiomyopathy: part 1 - introduction, pathology and pathophysiology. Ann. Card. Anaesth. 17, 118–124, https://doi.org/10.4103/0971-9784.129841 (2014). · DOI
  2. Papadopoulos, D. P. & Papademetriou, V. Hypertrophic and hypertensive hypertrophic cardiomyopathy–a true association? Angiology. 61, 92–99, https://doi.org/10.1177/0003319709331391 (2010). · DOI
  3. Herpin, D. Left ventricular hypertrophy of hypertensive origin: classical concepts and recent data. Rev. Med. Interne. 15, 30–36, https://doi.org/10.1016/s0248-8663(05)82127-7 (1994). · DOI
  4. Topol, E. J., Traill, T. A. & Fortuin, N. J. Hypertensive hypertrophic cardiomyopathy of the elderly. N. Engl. J. Med. 312, 277–283, 10.10.56/NEJM198501313120504 (1985). · DOI
  5. Gersh, B. J. et al. ACCF/AHA guideline for the diagnosis and treatment of hypertrophic cardiomyopathy: executive summary: a report of the American College of Cardiology Foundation/American Heart Association task force on practice guidelines. J. Thorac. Cardiovasc. Surg. 142, 1303–1338, https://doi.org/10.1016/j.jtcvs.2011.10.019 (2011). · DOI
  6. Elliott, P. M. et al. ESC guidelines on diagnosis and management of hypertrophic cardiomyopathy: the task force for the diagnosis and management of hypertrophic cardiomyopathy of the European Society of Cardiology (ESC). Eur. Heart J. 35, 2733–2779, https://doi.org/10.1093/eurheartj/ehu284 (2014). · DOI · Paper page
  7. Minami, Y. et al. Clinical implications of midventricular obstruction in patients with hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 57, 2346–2355, https://doi.org/10.1016/j.jacc.2011.02.033 (2011). · DOI
  8. Eriksson, M. J. et al. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J. Am. Coll. Cardiol. 39, 638–645, https://doi.org/10.1016/s0735-1097(01)01778-8 (2002). · DOI
  9. Wang, K., Li, M. & Hakonarson, H. ANNOVAR: functional annotation of genetic variants from high-throughput sequencing data. Nucleic Acids Res. 38, e164, https://doi.org/10.1093/nar/gkq603 (2010). · DOI
  10. Aslam, F., Haque, A., Foody, J. & Shirani, J. The frequency and functional impact of overlapping hypertension on hypertrophic cardiomyopathy: a single-center experience. J. Clin. Hypertens. (Greenwich). 12, 240–245, https://doi.org/10.1111/j.1751-7176.2009.00251.x (2010). · DOI
  11. Tarazi, R. C. & Levy, M. N. Cardiac responses to increased afterload. State-of-the-art review. Hypertension. 4, 8–18 (1982).
  12. Niimura, H. et al. Sarcomere protein gene mutations in hypertrophic cardiomyopathy of the elderly. Circulation. 105, 446–451, https://doi.org/10.1161/hc0402.102990 (2002). · DOI
  13. Deng, T., Ou, B., Zhu, T. & Xu, D. The effect of hypertension on cardiac structure and function in different types of hypertrophic cardiomyopathy: A single-center retrospective study. Clin. Exp. Hypertens. 41, 359–365, https://doi.org/10.1080/10641963.2018.1489543 (2019). · DOI
  14. Harrison, M. R., Grigsby, C. G., Souther, S. K., Smith, M. D. & DeMaria, A. N. Midventricular obstruction associated with chronic systemic hypertension and severe left ventricular hypertrophy. Am. J. Cardiol. 68, 761–765, https://doi.org/10.1016/0002-9149(91)90650-a (1991). · DOI
  15. Williams, L. & Frenneaux, M. Syncope in hypertrophic cardiomyopathy: mechanisms and consequences for treatment. Europace. 9, 817–822, https://doi.org/10.1093/europace/eum093 (2007). · DOI
  16. Sedaghat-Hamedani, F. et al. Clinical outcomes associated with sarcomere mutations in hypertrophic cardiomyopathy: a meta-analysis on 7675 individuals. Clin. Res. Cardiol. 107, 30–41, https://doi.org/10.1007/s00392-017-1155-5 (2018). · DOI
  17. Giese, A. E. et al. Impact of age and blood pressure on the lower arterial pressure limit for maintenance of consciousness during passive upright posture in healthy vasovagal fainters: preliminary observations. Europace. 6, 457–462, 463, https://doi.org/10.1016/j.eupc.2004.04.003 (2004). · DOI
  18. Shah, M. Hypertrophic cardiomyopathy. Cardiol. Young. 27, S25–S30, https://doi.org/10.1017/S1047951116002195 (2017). · DOI
  19. Gil, T. et al. Strain analysis of left ventricular function in the association of hypertrophic cardiomyopathy and systemic arterial hypertension. Arq. Bras. Cardiol., https://doi.org/10.5935/abc.20190176 (2019). · DOI

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Metadata

Authors
Luo, Q., Chen, J., Zhang, T., Tang, X., & Yu, B.
Venue
Scientific Reports
Publisher
Springer Science and Business Media LLC
Published
2020-01-15
Volume
10
Issue
1
ISSN
2045-2322
DOI
10.1038/s41598-019-57230-z
PMC
PMC6962215
Cited by
20
References
2
Language
en
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