Heart failure & cardiomyopathies

The Clinical Trajectory of NYHA Functional Class I Patients With Obstructive Hypertrophic Cardiomyopathy

JACC Heart FailPublished Registry-based cohort study

Authors' conclusion

Although NYHA functional class I patients with oHCM fared better than NYHA functional class II patients, more than one-fourth experienced adverse events over 5-year follow-up, especially if they were older, female, and/or had LA enlargement.

Study context

Population
Patients with obstructive hypertrophic cardiomyopathy (oHCM) in the SHaRe registryof 7,964 HCM in SHaRe
Participants
1,239 patients
Exposure
NYHA class I vs NYHA class II
  • NYHA In = 598
  • NYHA IIn = 641reference
Outcome
Composite of:
  • NYHA class III–IV symptoms
  • LVEF <50%
  • AF
  • Stroke
  • Ventricular arrhythmias
  • Septal reduction therapy
  • Ventricular assist device or transplantation
  • Death
Follow-up
5-year follow-up
Methodological detailsmulticentre
  • Multicentre

Main finding

As reported in the abstract

Composite event rate

P < 0.001

Observational data: associations, not effects.

Further findings

Factors associated with composite outcome in NYHA I

HR (95% CI)P value
LA diameter ≥45 mm1.56 (1.14–2.12)P = 0.005
Female sex1.61 (1.16–2.24)P = 0.003
OutcomeHR (per 10 years) (95% CI)P value
Factors associated with composite outcome in NYHA IOlder age1.21 (1.09–1.34)P < 0.001

Factors associated with composite outcome in NYHA I

Magnitude of LV outflow tract obstruction not associated with higher risk

Original publication

The Clinical Trajectory of NYHA Functional Class I Patients With Obstructive Hypertrophic Cardiomyopathy. JACC Heart Fail. Published 6 November 2024. doi:10.1016/j.jchf.2024.09.008

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