Skip to main content

This is a preview of improvements coming to the PMC website in October 2024. Learn more

Return to current site
PMC
Logo of British Heart Journal Link to view articles on publisher site
. 1995 Nov;74(5):508–516. doi: 10.1136/hrt.74.5.508

Left ventricular chamber dilatation in hypertrophic cardiomyopathy: related variables and prognosis in patients with medical and surgical therapy.

C Seiler 1, R Jenni 1, G Vassalli 1, M Turina 1, O M Hess 1
PMCID: PMC484070  PMID: 8562235

Abstract

BACKGROUND--To determine the incidence and prognosis of left ventricular dilatation and systolic dysfunction in 139 patients with hypertrophic cardiomyopathy during long term follow up. METHODS--Left ventricular chamber dilatation and systolic dysfunction (both together referred to as left ventricular chamber dilatation) were determined echocardiographically. Chamber dilatation was defined as an increase in the left ventricular end diastolic diameter of > 2% per year combined with a decrease in midventricular systolic fractional shortening of > 2% per year of follow up [10.3 (SD 6) years]. The predictive value for left ventricular chamber dilatation of clinical, invasive, and echocardiographic variables and its prognosis were assessed. RESULTS--In 119 of 139 individuals (86%), left ventricular chamber size and systolic function remained stable (group 1), and in 20/139 patients (14%) left ventricular chamber dilatation occurred during follow up (group 2). At baseline examination, symptoms such as dyspnoea and syncope occurred less often in group 1 than in group 2; New York Heart Association classification was lower in group 1 than in group 2 (P = 0.001). Left ventricular mass index relative to sex specific normal values was increased by 18% in group 1 and by 41% in group 2 (P = 0.04). Cumulative survival rates were slightly although not significantly higher in group 1 than in group 2. Event-free survival was significantly higher in group 1 than in group 2 (P < 0.05). CONCLUSIONS--(1) The development of left ventricular chamber dilatation and systolic dysfunction in hypertrophic cardiomyopathy occurs in approximately 1.5% of the patients per year. (2) Factors associated with left ventricular dilatation are dyspnoea, syncope, a higher functional classification, and a higher degree of left ventricular hypertrophy. (3) Patients with chamber dilatation have a worse prognosis than those without, particularly regarding quality of life.

Full text

PDF
508

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson R. P., Bonchek L. I., Grunkemeier G. L., Lambert L. E., Starr A. The analysis and presentation of surgical results by actuarial methods. J Surg Res. 1974 Mar;16(3):224–230. doi: 10.1016/0022-4804(74)90035-3. [DOI] [PubMed] [Google Scholar]
  2. Ando H., Imaizumi T., Urabe Y., Takeshita A., Nakamura M. Apical segmental dysfunction in hypertrophic cardiomyopathy: subgroup with unique clinical features. J Am Coll Cardiol. 1990 Dec;16(7):1579–1588. doi: 10.1016/0735-1097(90)90304-8. [DOI] [PubMed] [Google Scholar]
  3. Bourmayan C., Desnos M., Baragan J., Benoit P., Fernandez F., Hagege A., Gay J., Guerot C. Evolution d'une myocardiopathie hypertrophique obstructive vers une myocardiopathie dilatée. A propos de 4 cas. Arch Mal Coeur Vaiss. 1990 Apr;83(4):537–542. [PubMed] [Google Scholar]
  4. Devereux R. B., Alonso D. R., Lutas E. M., Gottlieb G. J., Campo E., Sachs I., Reichek N. Echocardiographic assessment of left ventricular hypertrophy: comparison to necropsy findings. Am J Cardiol. 1986 Feb 15;57(6):450–458. doi: 10.1016/0002-9149(86)90771-x. [DOI] [PubMed] [Google Scholar]
  5. Doi Y. L., McKenna W. J., Gehrke J., Oakley C. M., Goodwin J. F. M mode echocardiography in hypertrophic cardiomyopathy: diagnostic criteria and prediction of obstruction. Am J Cardiol. 1980 Jan;45(1):6–14. doi: 10.1016/0002-9149(80)90213-1. [DOI] [PubMed] [Google Scholar]
  6. Fighali S., Krajcer Z., Edelman S., Leachman R. D. Progression of hypertrophic cardiomyopathy into a hypokinetic left ventricle: higher incidence in patients with midventricular obstruction. J Am Coll Cardiol. 1987 Feb;9(2):288–294. doi: 10.1016/s0735-1097(87)80377-7. [DOI] [PubMed] [Google Scholar]
  7. Funakoshi M., Imamura M., Sasaki J., Fujino M., Kawano T., Sasaki Y., Nakashima Y., Motooka T., Fukuda K., Imagawa M. Seventeen year follow-up of a patient with hypertrophic cardiomyopathy which progressed to dilated cardiomyopathy. Jpn Heart J. 1984 Sep;25(5):805–809. doi: 10.1536/ihj.25.805. [DOI] [PubMed] [Google Scholar]
  8. Hess O. M., Schneider J., Gloor H. O., Lütolf U. M., Keiser G. Kongestive, hypertrophe Kardiomyopathie--Intermediärform der primären Herzmuskelerkrankungen. Z Kardiol. 1977 Feb;66(2):95–98. [PubMed] [Google Scholar]
  9. Hina K., Kusachi S., Iwasaki K., Nogami K., Moritani H., Kita T., Taniguchi G., Tsuji T. Progression of left ventricular enlargement in patients with hypertrophic cardiomyopathy: incidence and prognostic value. Clin Cardiol. 1993 May;16(5):403–407. doi: 10.1002/clc.4960160507. [DOI] [PubMed] [Google Scholar]
  10. Maron B. J., Epstein S. E., Roberts W. C. Hypertrophic cardiomyopathy and transmural myocardial infarction without significant atherosclerosis of the extramural coronary arteries. Am J Cardiol. 1979 Jun;43(6):1086–1102. doi: 10.1016/0002-9149(79)90139-5. [DOI] [PubMed] [Google Scholar]
  11. Maron B. J., Wolfson J. K., Epstein S. E., Roberts W. C. Intramural ("small vessel") coronary artery disease in hypertrophic cardiomyopathy. J Am Coll Cardiol. 1986 Sep;8(3):545–557. doi: 10.1016/s0735-1097(86)80181-4. [DOI] [PubMed] [Google Scholar]
  12. Okamoto S., Ozaki M., Konishi T., Nakano T. A case report of siblings with hypertrophic cardiomyopathy that progressed to dilated cardiomyopathy--case reports. Angiology. 1993 May;44(5):406–411. doi: 10.1177/000331979304400511. [DOI] [PubMed] [Google Scholar]
  13. Pelliccia F., Cianfrocca C., Romeo F. The progression of hypertrophic cardiomyopathy: dilatation of the left ventricle with supernormal systolic function. Int J Cardiol. 1990 Feb;26(2):232–234. doi: 10.1016/0167-5273(90)90041-3. [DOI] [PubMed] [Google Scholar]
  14. Schnittger I., Gordon E. P., Fitzgerald P. J., Popp R. L. Standardized intracardiac measurements of two-dimensional echocardiography. J Am Coll Cardiol. 1983 Nov;2(5):934–938. doi: 10.1016/s0735-1097(83)80242-3. [DOI] [PubMed] [Google Scholar]
  15. Seiler C., Hess O. M., Schoenbeck M., Turina J., Jenni R., Turina M., Krayenbuehl H. P. Long-term follow-up of medical versus surgical therapy for hypertrophic cardiomyopathy: a retrospective study. J Am Coll Cardiol. 1991 Mar 1;17(3):634–642. doi: 10.1016/s0735-1097(10)80176-7. [DOI] [PubMed] [Google Scholar]
  16. Shah P. M., Adelman A. G., Wigle E. D., Gobel F. L., Burchell H. B., Hardarson T., Curiel R., De La Calzada C., Oakley C. M., Goodwin J. F. The natural (and unnatural) history of hypertrophic obstructive cardiomyopathy. Circ Res. 1974 Aug;35(2):suppl II–II:195. [PubMed] [Google Scholar]
  17. Shimizu A., Oku Y., Matsuo K., Hashiba K. Hypertrophic cardiomyopathy progressing to a dilated cardiomyopathy-like feature in Noonan's syndrome. Am Heart J. 1992 Mar;123(3):814–816. doi: 10.1016/0002-8703(92)90534-3. [DOI] [PubMed] [Google Scholar]
  18. Spirito P., Chiarella F., Carratino L., Berisso M. Z., Bellotti P., Vecchio C. Clinical course and prognosis of hypertrophic cardiomyopathy in an outpatient population. N Engl J Med. 1989 Mar 23;320(12):749–755. doi: 10.1056/NEJM198903233201201. [DOI] [PubMed] [Google Scholar]
  19. Spirito P., Maron B. J., Bonow R. O., Epstein S. E. Occurrence and significance of progressive left ventricular wall thinning and relative cavity dilatation in hypertrophic cardiomyopathy. Am J Cardiol. 1987 Jul 1;60(1):123–129. doi: 10.1016/0002-9149(87)90998-2. [DOI] [PubMed] [Google Scholar]
  20. Spirito P., Maron B. J., Bonow R. O., Epstein S. E. Severe functional limitation in patients with hypertrophic cardiomyopathy and only mild localized left ventricular hypertrophy. J Am Coll Cardiol. 1986 Sep;8(3):537–544. doi: 10.1016/s0735-1097(86)80180-2. [DOI] [PubMed] [Google Scholar]
  21. Sutton M. G., Tajik A. J., Smith H. C., Ritman E. L. Angina in idiopathic hypertrophic subaortic stenosis. A clinical correlate of regional left ventricular dysfunction: a videometric and echocardiographic study. Circulation. 1980 Mar;61(3):561–568. doi: 10.1161/01.cir.61.3.561. [DOI] [PubMed] [Google Scholar]
  22. Turina J., Jenni R., Krayenbuehl H. P., Turina M., Rothlin M. Echocardiographic findings late after myectomy in hypertrophic obstructive cardiomyopathy. Eur Heart J. 1986 Aug;7(8):685–692. doi: 10.1093/oxfordjournals.eurheartj.a062123. [DOI] [PubMed] [Google Scholar]
  23. Yutani C., Imakita M., Ishibashi-Ueda H., Hatanaka K., Nagata S., Sakakibara H., Nimura Y. Three autopsy cases of progression to left ventricular dilatation in patients with hypertrophic cardiomyopathy. Am Heart J. 1985 Mar;109(3 Pt 1):545–553. doi: 10.1016/0002-8703(85)90561-7. [DOI] [PubMed] [Google Scholar]
  24. ten Cate F. J., Roelandt J. Progression to left ventricular dilatation in patients with hypertrophic obstructive cardiomyopathy. Am Heart J. 1979 Jun;97(6):762–765. doi: 10.1016/0002-8703(79)90012-7. [DOI] [PubMed] [Google Scholar]

Articles from British Heart Journal are provided here courtesy of BMJ Publishing Group

RESOURCES

-