Value of Doppler-echocardiography in the prognosis and follow up of hypertrophic myocardiopathy

• Published in: Revista española de cardiologia Vol. 54; no. 1; pp. 7 - 15
• Main Authors: Candell Riera, J, Romero Farina, G, Galve Basilio, E, Palet Balart, J, Armadans, L, Dolores Reina, M, García del Castillo, H, Soler Soler, J
• Format: Journal Article
• Language: Spanish
• Published: Spain 01.01.2001
• Subjects: Cardiomyopathy, Hypertrophic - complications; Cardiomyopathy, Hypertrophic - diagnostic imaging; Echocardiography, Doppler; Female; Follow-Up Studies; Humans; Male; Middle Aged; Prognosis
• ISSN: 0300-8932

The aim of this study was to assess the value of Doppler-echocardiogram for the prognosis and follow up of a hospital-based series of adult patients with hypertrophic cardiomyopathy (HC). One-hundred nineteen consecutive patients with HC (52 +/- 12 years, 60 women) were studied over a follow up period of 9.7 +/- 6.7 years. Echocardiographic evolution was analyzed in 104 patients (67 with dynamic obstruction) who had, at least, two echocardiograms performed within an interval of 3.7 +/- 3 years (1 to 7 years). Seven patients died during follow up and 31 patients developed severe complications (7 deaths, 15 syncopes, 4 class IV angina, 3 class IV dyspnea and 2 acute myocardial infarctions). The presence of mitral insufficiency (p = 0.001) and dynamic gradient > 50 mmHg (p = 0.02) were predictive of mortality and a left atrial index > 25 mm/m2 was predictive (p = 0.028) of severe complications. Fifteen percent of the patients without dynamic obstruction in the first Doppler-echo showed a gradient > 25 mmHg in the last echo. A greater number of patients with mitral insufficiency (80% vs 66%; p = 0.01) and an increase in its severity (p = 0.038) was observed during follow up. Mitral insufficiency, a dynamic gradient > 50 mmHg and a left atrial index > 25 mm/m2 are variables of a bad prognosis in adult patients with HC. An evolution to obstructive HC was observed in 15% of non obstructive HC, and a tendency to increased severity of mitral insufficiency was observed during follow up.