Heart failure & cardiomyopathies
Myocardial Work in Children With Hypertrophic Cardiomyopathy: Longitudinal Evaluation and Prognostic Implications
Authors' conclusion
In pediatric HCM, MW declines over time and is linked to adverse outcomes but remains primarily a research tool, with no superior risk stratification compared to global longitudinal strain.
Study context
- Population
- Pediatric patients with hypertrophic cardiomyopathy (HCM), compared with a family history group and healthy controlspatients with HCM, median age 11.9 years [7.7–14.5], 50% males
- Participants
- 74 patients
- Comparison
- Myocardial work (MW) indices in HCM compared with a family history group (FH) and healthy controls
- HCMn = 74
- FHn = 72
- Healthy controlsn = 50
- Outcome
- Composite endpoint encompassing all-cause mortality, SCD, aborted SCD, appropriate implantable cardioverter-defibrillator discharge, and sustained ventricular tachycardia
Main finding
As reported in the abstract
- Lower GWI and global constructive work (GCW) were positively associated with the composite endpoint
- both P < 0.001
Further findings
| Outcome | P value |
|---|---|
| MW indices at baseline, between groupsHCM vs FH · GWI lower in HCM | pairwise P = 0.012 |
| MW indices at baseline, between groupsHCM vs FH · GCW lower in HCM | P < 0.001 |
| MW indices at baseline, between groupsHCM vs FH · GWE lower in HCM | P = 0.001 |
| MW indices at baseline, between groupsHCM vs healthy controls · only GCW and GWE significantly lower in HCM | both pairwise P < 0.001 |
MW indices at baseline, between groups
- MW indices differed significantly between groups at baseline
Change in MW indices in HCM during follow-up · 4.9 years [2.9-8.8]
- Decrease in GWI
- P = 0.002
- Decrease in GCW
- P = 0.001
- Global wasted work, no significant change
- P = 0.665
- Global work efficiency (GWE), no significant change
- P = 0.126
- FH patients exhibited stable MW indices over time
Original publication
Myocardial Work in Children With Hypertrophic Cardiomyopathy: Longitudinal Evaluation and Prognostic Implications. JACC Adv. Published 17 June 2025. doi:10.
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