Heart failure & cardiomyopathiesCohort study
Clinical Spectrum and Outcomes in Hypertrophic Cardiomyopathy With Apical Aneurysms
- cohort
- 10 centers
- multivariable Cox proportional hazard models
Authors' conclusion
In a large cohort of HCM patients with apical aneurysms, rates of SCD events were high, with continuous relationship between size and risk. Small aneurysms (<10 mm) were associated with low risk for SCD events (0.2%/year), whereas aneurysms ≥10 mm with high risk (>2%/year). Although embolic events were uncommon, increasing aneurysm size was associated with the prevalence of apical thrombi.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM) and apical aneurysmsfollowed a median of 4.1 years
- Participants
- 510 patients
- Exposure
- Aneurysm size and sudden cardiac death (SCD) events and apical thrombus/thromboembolism
Main finding
As reported in the abstract
Distribution of aneurysm size
Observational data: associations, not effects.
Further findings
| Outcome | small | medium | large | very large |
|---|---|---|---|---|
| SCD events (SCD, appropriate implantable cardioverter defibrillator therapy, and resuscitated SCD) · median 4.1 years | 0.2%/year | 2.3%/year | 3.0%/year | 8.2%/year |
| Embolic event or apical thrombus | 3% | Not reported in the abstract | Not reported in the abstract | 25% |
- SCD events (SCD, appropriate implantable cardioverter defibrillator therapy, and resuscitated SCD) — Overall SCD event rate
- 2.1%/year
- SCD events (SCD, appropriate implantable cardioverter defibrillator therapy, and resuscitated SCD) — Risk increasing with increasing aneurysm size
- P < 0.001
- Embolic event or apical thrombus — Embolic event
- 3.6% of patients
- Embolic event or apical thrombus — Apical thrombus
- 10% of patients
- Embolic event or apical thrombus — Either an embolic event or apical thrombus
- 13% of patients
- Embolic event or apical thrombus — Independently associated with greater aneurysm size
- P < 0.001
SCD events (SCD, appropriate implantable cardioverter defibrillator therapy, and resuscitated SCD) · median 4.1 years
- On multivariable analysis, greater size associated with SCD events, independent of other risk markers or European Society of Cardiology-SCD score
Original publication
Clinical Spectrum and Outcomes in Hypertrophic Cardiomyopathy With Apical Aneurysms. JACC Adv. Published 17 June 2026. doi:10.1016/j.jacadv.2026.102919
Summarised from the published abstract; every number is checked against it