Heart failure & cardiomyopathies
Prognostic Implications of Mitral Regurgitation Across Hypertrophic Cardiomyopathy Subtypes: A Report From REVEAL-HCM Study
Authors' conclusion
In patients with HCM, moderate or greater MR was not associated with worse outcomes in HOCM or ES-HCM, but had significant prognostic implications in other HCM subtypes, suggesting the need for HCM subtype-specific MR management.
Study context
- Population
- Patients with hypertrophic cardiomyopathy (HCM), compared by mitral regurgitation (MR) severity within each subtype: Hypertrophic obstructive cardiomyopathy (HOCM), end-stage HCM (ES-HCM) and other HCM (including nonobstructive, midventricular obstruction, and apical HCM)HOCM 837 · ES-HCM 275 · other HCM 2,490
- Participants
- 3,602 patients
- Exposure
- MR severity within each subtype
Methodological detailsretrospectively included
- Retrospectively included
Main finding
As reported in the abstract
Prevalence of moderate or greater MR, by subtype
HOCM
36.3%
ES-HCM
21.5%
Other HCM
8.5%
Observational data: associations, not effects.
Further findings
| Outcome | Moderate or greater MR | Mild or less MR | Hazard ratio (95% CI) | P value | |
|---|---|---|---|---|---|
| All-cause death or heart failure hospitalization, HOCM · 5-year cumulative incidence; median follow-up 5.3 (interquartile range, 2.1-9.3) years · after adjustment for clinical covariates | 14.6% | 12.4% | 1.13 (0.79–1.60) | P = 0.51 | |
| All-cause death or heart failure hospitalization, ES-HCM · 5-year cumulative incidence · after adjustment for clinical covariates | 60.7% | 54.7% | 0.84 (0.55–1.28) | P = 0.42 | |
| All-cause death or heart failure hospitalization, other HCM · 5-year cumulative incidence · after adjustment | 34.2% | 13.9% | 1.45 (1.09–1.91) | P = 0.01 | |
| 0.512Hazard ratio (log scale) |
- All-cause death or heart failure hospitalization, HOCM: unadjusted P =0.35
- All-cause death or heart failure hospitalization, ES-HCM: unadjusted P =0.84
- All-cause death or heart failure hospitalization, other HCM: unadjusted P <0.001
- All-cause death or heart failure hospitalization, other HCM: P interaction =0.02
Change in MR severity over time
- HOCM: improved
- P < 0.001
- ES-HCM: no clear change
- 0.46
- Other HCM: worsened
- <0.001
- P interaction <0.001
Original publication
Prognostic Implications of Mitral Regurgitation Across Hypertrophic Cardiomyopathy Subtypes: A Report From REVEAL-HCM Study. Circ Heart Fail. Published 4 February 2026. doi:10.
Summarised from the published abstract; every number is checked against it