TY - JOUR
T1 - Apical hypertrophic cardiomyopathy
T2 - Prevalence and correlates of apical outpouching
AU - Binder, Josepha
AU - Attenhofer Jost, Christine H.
AU - Klarich, Kyle W.
AU - Connolly, Heidi M.
AU - Tajik, A. Jamil
AU - Scott, Christopher G.
AU - Julsrud, Paul R.
AU - Ehrsam, Jo Ellen
AU - Bailey, Kent R.
AU - Ommen, Steve R.
PY - 2011/7
Y1 - 2011/7
N2 - Background: Apical outpouching, including wall motion abnormalities and aneurysms, has been described in apical hypertrophic cardiomyopathy (ApHCM). Methods: Between 1976 and 2006, 193 patients with ApHCM (120 men; overall mean age, 61 ± 17 years) were evaluated. Results: Apical outpouching was found in 29 patients (15%) and in 22 of the 78 patients (28%) imaged with contrast echocardiography. Six patients had apical aneurysms, and 23 patients had hypokinesis with apical dilatation but no wall thinning. Apical outpouching was more common in patients with diastolic gradients out of the apex (P < .001), corrected QT interval prolongation (P < .001), increased apical wall thickness (P = .01), and family histories of sudden cardiac death (P = .03). Sudden cardiac death, resuscitated cardiac arrest, or discharge of an automated internal cardiac defibrillator, or a combination, was observed in 11 patients (6%) during follow-up. Atrial fibrillation (28%), ventricular tachycardia (20%), and stroke (11%) were also relatively common in this study. No difference was observed in overall mortality rate comparing patients with ApHCM with and without apical outpouching. Similarly, no differences were found in the rates of sudden cardiac death, resuscitated cardiac arrest, and discharge of an automated internal cardiac defibrillator. The impact of true aneurysms was not assessed in this study. Conclusions: Cardiac complications appear commonly in patients with ApHCM, but they did not seem to be related to apical outpouching in the present analysis.
AB - Background: Apical outpouching, including wall motion abnormalities and aneurysms, has been described in apical hypertrophic cardiomyopathy (ApHCM). Methods: Between 1976 and 2006, 193 patients with ApHCM (120 men; overall mean age, 61 ± 17 years) were evaluated. Results: Apical outpouching was found in 29 patients (15%) and in 22 of the 78 patients (28%) imaged with contrast echocardiography. Six patients had apical aneurysms, and 23 patients had hypokinesis with apical dilatation but no wall thinning. Apical outpouching was more common in patients with diastolic gradients out of the apex (P < .001), corrected QT interval prolongation (P < .001), increased apical wall thickness (P = .01), and family histories of sudden cardiac death (P = .03). Sudden cardiac death, resuscitated cardiac arrest, or discharge of an automated internal cardiac defibrillator, or a combination, was observed in 11 patients (6%) during follow-up. Atrial fibrillation (28%), ventricular tachycardia (20%), and stroke (11%) were also relatively common in this study. No difference was observed in overall mortality rate comparing patients with ApHCM with and without apical outpouching. Similarly, no differences were found in the rates of sudden cardiac death, resuscitated cardiac arrest, and discharge of an automated internal cardiac defibrillator. The impact of true aneurysms was not assessed in this study. Conclusions: Cardiac complications appear commonly in patients with ApHCM, but they did not seem to be related to apical outpouching in the present analysis.
KW - Apical aneurysm
KW - Apical hypertrophic cardiomyopathy
KW - Apical outpouching
KW - Echocardiography
KW - Ischemia
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U2 - 10.1016/j.echo.2011.03.002
DO - 10.1016/j.echo.2011.03.002
M3 - Article
C2 - 21511435
AN - SCOPUS:79959537766
SN - 0894-7317
VL - 24
SP - 775
EP - 781
JO - Journal of the American Society of Echocardiography
JF - Journal of the American Society of Echocardiography
IS - 7
ER -