Abstract
The presence of syncope despite medical therapy in patients with hypertrophic cardiomyopathy (HC) is considered an indication for surgical myectomy; however, no study has examined the long-term effects on recurrent syncope and survival after surgery in these patients. We examined 239 patients with HC and a history of syncope who had undergone surgical myectomy (mean age 48 ± 17 years; 56% men). The patients were age- and gender-matched to patients with HC and syncope who were treated medically without myectomy (mean age 51 ± 16 years; 59% men). The median follow-up period was 4.7 years (0.8, 11.3). The recurrence rate of syncope was 11% in the myectomy patients and 40% in the medical group (p <0.0001). Multiple episodes of syncope, left ventricular outflow tract obstruction, and recent syncope were identified as baseline predictors of recurrent syncope. Survival free of all-cause mortality was greater for patients who had undergone surgical myectomy than for the medically treated patients (10-year estimate 82 ± 4% vs 69 ± 4%; p = 0.01). In conclusion, surgical myectomy in patients with HC and a history of syncope was associated with a reduction in recurrent syncope and increased survival.
| Original language | English (US) |
|---|---|
| Pages (from-to) | 388-392 |
| Number of pages | 5 |
| Journal | American Journal of Cardiology |
| Volume | 111 |
| Issue number | 3 |
| DOIs | |
| State | Published - Feb 1 2013 |
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ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
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Comparison of surgical septal myectomy to medical therapy alone in patients with hypertrophic cardiomyopathy and syncope. / Orme, Nicholas M.; Sorajja, Paul; Dearani, Joseph A.; Schaff, Hartzell V; Gersh, Bernard J.; Ommen, Steve R.
In: American Journal of Cardiology, Vol. 111, No. 3, 01.02.2013, p. 388-392.Research output: Contribution to journal › Article
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TY - JOUR
T1 - Comparison of surgical septal myectomy to medical therapy alone in patients with hypertrophic cardiomyopathy and syncope
AU - Orme, Nicholas M.
AU - Sorajja, Paul
AU - Dearani, Joseph A.
AU - Schaff, Hartzell V
AU - Gersh, Bernard J.
AU - Ommen, Steve R.
PY - 2013/2/1
Y1 - 2013/2/1
N2 - The presence of syncope despite medical therapy in patients with hypertrophic cardiomyopathy (HC) is considered an indication for surgical myectomy; however, no study has examined the long-term effects on recurrent syncope and survival after surgery in these patients. We examined 239 patients with HC and a history of syncope who had undergone surgical myectomy (mean age 48 ± 17 years; 56% men). The patients were age- and gender-matched to patients with HC and syncope who were treated medically without myectomy (mean age 51 ± 16 years; 59% men). The median follow-up period was 4.7 years (0.8, 11.3). The recurrence rate of syncope was 11% in the myectomy patients and 40% in the medical group (p <0.0001). Multiple episodes of syncope, left ventricular outflow tract obstruction, and recent syncope were identified as baseline predictors of recurrent syncope. Survival free of all-cause mortality was greater for patients who had undergone surgical myectomy than for the medically treated patients (10-year estimate 82 ± 4% vs 69 ± 4%; p = 0.01). In conclusion, surgical myectomy in patients with HC and a history of syncope was associated with a reduction in recurrent syncope and increased survival.
AB - The presence of syncope despite medical therapy in patients with hypertrophic cardiomyopathy (HC) is considered an indication for surgical myectomy; however, no study has examined the long-term effects on recurrent syncope and survival after surgery in these patients. We examined 239 patients with HC and a history of syncope who had undergone surgical myectomy (mean age 48 ± 17 years; 56% men). The patients were age- and gender-matched to patients with HC and syncope who were treated medically without myectomy (mean age 51 ± 16 years; 59% men). The median follow-up period was 4.7 years (0.8, 11.3). The recurrence rate of syncope was 11% in the myectomy patients and 40% in the medical group (p <0.0001). Multiple episodes of syncope, left ventricular outflow tract obstruction, and recent syncope were identified as baseline predictors of recurrent syncope. Survival free of all-cause mortality was greater for patients who had undergone surgical myectomy than for the medically treated patients (10-year estimate 82 ± 4% vs 69 ± 4%; p = 0.01). In conclusion, surgical myectomy in patients with HC and a history of syncope was associated with a reduction in recurrent syncope and increased survival.
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UR - http://www.scopus.com/inward/citedby.url?scp=84872335139&partnerID=8YFLogxK
U2 - 10.1016/j.amjcard.2012.10.014
DO - 10.1016/j.amjcard.2012.10.014
M3 - Article
C2 - 23168291
AN - SCOPUS:84872335139
VL - 111
SP - 388
EP - 392
JO - American Journal of Cardiology
JF - American Journal of Cardiology
SN - 0002-9149
IS - 3
ER -