PMID- 37302651
OWN - NLM
STAT- MEDLINE
DCOM- 20231102
LR  - 20231114
IS  - 1873-1740 (Electronic)
IS  - 0033-0620 (Linking)
VI  - 80
DP  - 2023 Sep-Oct
TI  - Patient reported outcomes in obstructive hypertrophic cardiomyopathy undergoing 
      myectomy: Results from SPIRIT-HCM study.
PG  - 66-73
LID - S0033-0620(23)00057-9 [pii]
LID - 10.1016/j.pcad.2023.06.001 [doi]
AB  - BACKGROUND: Patient reported outcomes (PRO) can assess quality of life (QOL) in 
      obstructive hypertrophic cardiomyopathy (oHCM). In symptomatic oHCM patients, we 
      sought to study the correlation between various PROs, their association with 
      physician reported New York Heart Association (NYHA) class and changes after 
      surgical myectomy. METHODS: We prospectively studied 173 symptomatic oHCM 
      patients undergoing myectomy (age 51 years, 62% men) between 3/17-6/20. PROs, 
      including a) Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score b) 
      Patient-Reported Outcomes Measurement Information System [PROMIS] c) Duke 
      Activity Status Index [DASI] & d) European QOL score [EQ-5D], along with NYHA 
      class, 6-min walk test (6MWT) distance and peak left ventricular outflow tract 
      gradient (PLVOTG) were recorded at baseline and 12 month follow-up. RESULTS: The 
      median baseline PRO scores (KCCQ summary, PROMIS physical, PROMIS mental, DASI, 
      EQ-5D) were 50, 67, 63, 25, 50, 37, 44, 25 and 0.61, respectively; 6MWT distance 
      was 366 m. There were significant correlations between various PROs (r-values 
      between 0.66 and 0.92, p < 0.001), but only modest correlations with 6MWT and 
      provokable LVOTG (r-values between 0.2 and 0.5, p < 0.01). At baseline, 35-49% 
      patients in NYHA class II had PROs worse than median, while 30-39% patients in 
      NYHA Class III/IV had PROs better than median. At follow-up, a 20 point 
      improvement in KCCQ summary score was observed in 80%, 4 point improvement in 
      DASI score in 83%, 4 point improvement in PROMIS physical score 86% and a 0.04 
      point improvement in EQ-5D in 85%); along with improvements in NYHA class (67% in 
      Class I) and peak LVOTG (median 13 mmHg) and 6MWT (median distance 438 m). 
      CONCLUSIONS: In a prospective study of symptomatic oHCM patients, surgical 
      myectomy significantly improved PROs, LVOT obstruction, and functional capacity, 
      with a high correlation between various PROs. However, there was high rate of 
      discordance between PROs and NYHA class. STUDY REGISTRATION: ClinicalTrials.gov: 
      NCT03092843.
CI  - Copyright (c) 2023 Elsevier Inc. All rights reserved.
FAU - Tower-Rader, Albree
AU  - Tower-Rader A
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America; Department of Cardiovascular 
      Medicine, Massachusetts General Hospital, Boston, MA, United States of America.
FAU - Szpakowski, Natalie
AU  - Szpakowski N
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Popovic, Zoran B
AU  - Popovic ZB
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Bittel, Barabara
AU  - Bittel B
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Fava, Agostina
AU  - Fava A
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Ospina, Susan
AU  - Ospina S
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Xu, Bo
AU  - Xu B
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Thamilarasan, Maran
AU  - Thamilarasan M
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Mentias, Amgad
AU  - Mentias A
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Smedira, Nicholas G
AU  - Smedira NG
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America.
FAU - Desai, Milind Y
AU  - Desai MY
AD  - Hypertrophic Cardiomyopathy Center, Heart and Vascular Institute, Cleveland 
      Clinic, Cleveland, OH, United States of America. Electronic address: 
      desaim2@ccf.org.
LA  - eng
SI  - ClinicalTrials.gov/NCT03092843
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20230609
PL  - United States
TA  - Prog Cardiovasc Dis
JT  - Progress in cardiovascular diseases
JID - 0376442
SB  - IM
MH  - Male
MH  - Humans
MH  - Middle Aged
MH  - Female
MH  - *Quality of Life
MH  - Treatment Outcome
MH  - Prospective Studies
MH  - *Cardiomyopathy, Hypertrophic/diagnosis/surgery/complications
MH  - Patient Reported Outcome Measures
OTO - NOTNLM
OT  - Myectomy
OT  - Obstructive hypertrophic cardiomyopathy
OT  - Quality of life
COIS- Declaration of Competing Interest Dr. Desai is a consultant for Bristol Myers 
      Squibb, Cytokinetics, Tenaya and Medtronic. Dr. Tower-Rader is a consultant for 
      Bristol Myers Squibb and Cytokinetics. Dr. Smedira is a consultant for Bristol 
      Myers Squibb. Others have no conflicts.
EDAT- 2023/06/12 00:42
MHDA- 2023/06/12 00:43
CRDT- 2023/06/11 19:16
PHST- 2023/06/08 00:00 [received]
PHST- 2023/06/08 00:00 [accepted]
PHST- 2023/06/12 00:43 [medline]
PHST- 2023/06/12 00:42 [pubmed]
PHST- 2023/06/11 19:16 [entrez]
AID - S0033-0620(23)00057-9 [pii]
AID - 10.1016/j.pcad.2023.06.001 [doi]
PST - ppublish
SO  - Prog Cardiovasc Dis. 2023 Sep-Oct;80:66-73. doi: 10.1016/j.pcad.2023.06.001. Epub 
      2023 Jun 9.