Clinical Characteristics and Long-Term Outcomes in Patients with Apical Hypertrophic Cardiomyopathy

Guo, M; Liu, C; Ye, J; Liu, J

doi:10.1002/ehf2.15298

Clinical Characteristics and Long-Term Outcomes in Patients with Apical Hypertrophic Cardiomyopathy

ESC Heart FailPublished 13 Apr 2025single-centre retrospective study

Main finding · Major adverse cardiac events in hospital and during follow-upResultAdjusted hazard ratio 0.360 95% CI 0.187–0.696

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Authors' conclusion

Patients with ApHCM may have better prognosis. LVEF and age were independent predictors of long-term outcomes in ApHCM.

Study context

Population: Patients with hypertrophic cardiomyopathy (HCM), divided into apical HCM (ApHCM) and non-ApHCM groups379 patients completed the follow-up
Participants: 479 patients

Exposure: ApHCM vs non-ApHCM
ApHCMn = 109
non-ApHCMn = 370
Outcome: Major adverse cardiac events in hospital and during follow-up
Follow-up: Median 5.59 (2.33-10.30) years

Main finding

As reported in the abstract

Adjusted hazard ratio

0.360

95% CI 0.187–0.696

P = 0.002

By group

ApHCM11.4%

non-ApHCM27.2%

ApHCMvs non-ApHCM

HRadj 0.360 (95% CI 0.187–0.696); P = 0.002

Observational data: associations, not effects.

Further findings

Outcome	← Lower risk with ApHCM ←→ Higher risk with ApHCM →	HRadj (95% CI)	P value
All-cause death	0.050.21520	0.545 (0.305–0.975)	P = 0.041
Fatal ventricular arrhythmia or appropriate implantable cardioverter defibrillator intervention	0.050.21520	0.099 (0.013–0.724)	P = 0.023
	0.050.21520Adjusted hazard ratio (log scale)

Independent predictors of the composite outcome in ApHCM

	← Lower risk ←→ Higher risk →	HRadj (95% CI)	P value
LVEF	0.512	0.861 (0.763–0.971)	P = 0.015
Age	0.512	1.247 (1.095–1.419)	P = 0.001
	0.512Adjusted hazard ratio (log scale)

Baseline characteristics

Age of enrolled patients: 61.0 (50.0-69.0) years
Male: 289 (60.3%)
Age at diagnosis, ApHCM vs non-ApHCM: 55.0 (45.0-64.0) vs. 50.0 (40.0-61.0) years, P = 0.006
Positive family history for HCM, ApHCM vs non-ApHCM: 3 (2.8%) vs. 34 (9.2%), P = 0.027
Electrocardiographic abnormalities, ApHCM vs non-ApHCM: 101 (92.7%) vs. 287 (77.6%), P < 0.001
Brain natriuretic peptide, ApHCM vs non-ApHCM: 135.5 (60.8-272.8) vs. 422.5 (182.8-888.2) pg/mL, P < 0.001
Left ventricular ejection fraction (LVEF), ApHCM vs non-ApHCM: 69.00 (64.00-73.87) vs. 67.00 (60.24-73.45) %, P = 0.048

Original publication

Clinical Characteristics and Long-Term Outcomes in Patients with Apical Hypertrophic Cardiomyopathy. ESC Heart Fail. Published 13 April 2025. doi:10.1002/ehf2.15298

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