PMID- 18657666
OWN - NLM
STAT- MEDLINE
DCOM- 20080805
LR  - 20161124
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 156
IP  - 2
DP  - 2008 Aug
TI  - Clinical characteristics and outcomes of patients with hypertrophic 
      cardiomyopathy with latent obstruction.
PG  - 342-7
LID - 10.1016/j.ahj.2008.04.002 [doi]
AB  - BACKGROUND: The purpose of this article is to describe the demographic and 
      clinical features of patients with hypertrophic cardiomyopathy (HCM) and latent 
      obstruction, with an emphasis on identifying factors associated with disease 
      progression and survival. The presence of a resting left ventricular outflow 
      obstruction in patients with HCM has been well described and is associated with 
      increased symptoms and adverse long-term outcomes. However, less is known about 
      patients with latent obstruction. METHODS: Four hundred fifteen patients with 
      echocardiographic or catheterization findings of latent obstruction, defined as a 
      left ventricular outflow pressure gradient <30 mm Hg at rest, which increases to 
      > or =30 mm Hg with provocation, were identified and included in the study group. 
      RESULTS: The mean age was 55.0 +/- 17.9, and 226 (54.6%) patients were male. 
      There were 330 (79.5%) patients with New York Heart Association (NYHA) functional 
      class I and II at baseline. Fifty-nine (17.9%) of these patients had symptom 
      progression requiring septal reduction therapy. Eighty-five patients had severe 
      symptoms (NYHA functional class III and IV) at baseline, and 23 (27.1%) underwent 
      septal reduction. Overall survival at 1, 5, and 10 years was 98%, 91%, and 81%, 
      respectively. Survival among patients after undergoing invasive relief of outflow 
      obstruction was equivalent to the general US population. CONCLUSIONS: Latent 
      obstruction in HCM is an important pathophysiologic entity and may cause heart 
      failure symptoms. One-third of patients in this referral series required invasive 
      therapy for relief of symptoms. The evaluation of HCM patients with resting 
      outflow tract gradients <30 mm Hg must include provocative maneuvers to identify 
      this substantial subset of patients, preferably by physiologic exercise.
FAU - Vaglio, Joseph C Jr
AU  - Vaglio JC Jr
AD  - Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic and Mayo 
      Foundation, Rochester, MN, USA. jvaglio@yahoo.com
FAU - Ommen, Steve R
AU  - Ommen SR
FAU - Nishimura, Rick A
AU  - Nishimura RA
FAU - Tajik, A Jamil
AU  - Tajik AJ
FAU - Gersh, Bernard J
AU  - Gersh BJ
LA  - eng
PT  - Journal Article
DEP - 20080606
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - Analysis of Variance
MH  - Cardiac Catheterization
MH  - Cardiomyopathy, Hypertrophic/*complications
MH  - Disease Progression
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - Mitral Valve Insufficiency/etiology
MH  - Prognosis
MH  - Retrospective Studies
MH  - Survival Analysis
MH  - Ultrasonography
MH  - Ventricular Outflow Obstruction/diagnostic imaging/*etiology
EDAT- 2008/07/29 09:00
MHDA- 2008/08/06 09:00
CRDT- 2008/07/29 09:00
PHST- 2007/08/22 00:00 [received]
PHST- 2008/04/01 00:00 [accepted]
PHST- 2008/07/29 09:00 [pubmed]
PHST- 2008/08/06 09:00 [medline]
PHST- 2008/07/29 09:00 [entrez]
AID - S0002-8703(08)00275-5 [pii]
AID - 10.1016/j.ahj.2008.04.002 [doi]
PST - ppublish
SO  - Am Heart J. 2008 Aug;156(2):342-7. doi: 10.1016/j.ahj.2008.04.002. Epub 2008 Jun 
      6.