The DOI matches its Crossref record; 32 of the 33 references it cites were found in a registry or an index.
Treatment of Obstructive Hypertrophic Cardiomyopathy Symptoms and Gradient Resistant to First-Line Therapy With β-Blockade or Verapamil
Open accessAbstract
BACKGROUND: There is controversy about preferred methods to relieve obstruction in hypertrophic cardiomyopathy patients still symptomatic after β-blockade or verapamil. METHODS AND RESULTS: Of 737 patients prospectively registered at our institution, 299 (41%) required further therapy for obstruction for limiting symptoms, rest gradient 61 ± 45, provoked gradient 115 ± 49 mm Hg, and followed up for 4.8 years. Disopyramide was added in 221 (74%) patients and pharmacological control of symptoms was achieved in 141 (64%) patients. Overall, 138 (46%) patients had surgical relief of obstruction (91% myectomy) and 6 (2%) alcohol septal ablation. At follow-up, resting gradients in the 299 patients had decreased from 61 ± 44 to 10 ± 25 mm Hg (P<0.0001); New York Heart Association class decreased from 2.7 ± 0.7 to 1.8 ± 0.5 (P<0.0001). Kaplan-Meier survival at 10 years in the 299 advanced-care patients was 88% and did not differ from nonobstructed patients (P=0.28). Only 1 patient had sudden death, a low annual rate of 0.06%/y. Kaplan-Meier survival at 10 years in the advanced-care patients did not differ from that expected in a matched cohort of the US population (P=0.90). CONCLUSIONS: Patients with obstruction and symptoms resistant to initial pharmacological therapy with β-blockade or verapamil may realize meaningful symptom relief and low mortality through stepped management, adding disopyramide in appropriately selected patients, and when needed, by surgical myectomy.
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“Disopyramide has been shown in retrospective studies to be safe and associated with an improvement in both LVOT gradient and symptoms when used in combination with β blockers or non-dihydropyridine CCBs.”
From Current management of hypertrophic cardiomyopathy (2025) · cites this paper as [31]
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“has been shown to reduce LV outflow gradient and improve symptoms in patients with hypertrophic cardiomyopathy.[662][663][664]”
From 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS (2016) · cites this paper as [664]
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2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS
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2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy
Authors/Task Force members, Elliott, P. M., Anastasakis, A., Borger, M. A., Borggrefe, M., Cecchi, F., Charron, P., Hagege, A. A., Lafont, A., Limongelli, G., et al. (2014) · European Heart Journal · doi:10.1093/eurheartj/ehu284 · Cited by 4,332
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Kirchhof, P., Benussi, S., Kotecha, D., Ahlsson, A., Atar, D., Casadei, B., Castella, M., Diener, H.-C., Heidbuchel, H., Hendriks, J., et al. (2016) · European Journal of Cardio-Thoracic Surgery · doi:10.1093/ejcts/ezw313 · Cited by 1,403
Metadata
- Authors
- Sherrid, M. V., Shetty, A., Winson, G., Kim, B., Musat, D., Alviar, C. L., Homel, P., Balaram, S. K., & Swistel, D. G.
- Affiliations
- St. Luke's-Roosevelt Hospital Center (US)
- ORCID
- Venue
- Circulation Heart Failure
- Published
- 2013-07
- Volume
- 6
- Issue
- 4
- Pages
- 694-702
- ISSN
- 1941-3289 (ISSN-L)
- 1941-3297
- OpenAlex
- W2122819292
- Cited by
- 178
- References
- 33
- Citations by year
- 2026: 11 · 2025: 26 · 2024: 26 · 2023: 12 · 2022: 14 · 2021: 13 · 2020: 11 · 2019: 6 · 2018: 13 · 2017: 7 · 2016: 14 · 2015: 10 · 2014: 13 · 2013: 1
- FWCI
- 8.65
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Circulation Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiomyopathy and Myosin Studies
- Health Sciences › Medicine › Infectious Diseases › Viral Infections and Immunology Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Valve Diseases and Treatments
- Keywords
- hypertrophic obstructive cardiomyopathy, left ventricular outflow tract obstruction, disopyramide, beta-adrenergic blockade, verapamil, myectomy, alcohol septal ablation, symptom relief, survival, sudden death
- MeSH terms
- Adrenergic beta-Antagonists, Aged, Anti-Arrhythmia Agents, Calcium Channel Blockers, Cardiomyopathy, Hypertrophic, Combined Modality Therapy, Disopyramide, Female, Cardiac Surgical Procedures, Humans, Male, Middle Aged, Verapamil, Treatment Failure
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