Heart failure & cardiomyopathiesCohort study
The Clinical Trajectory of NYHA Functional Class I Patients With Obstructive Hypertrophic Cardiomyopathy
- Registry-based cohort study
- multicentre
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
Main finding
As reported in the abstract
Composite event rate
P < 0.001
Observational data: associations, not effects.
Further findings
| Outcome | Estimate | P value | |
|---|---|---|---|
| Factors associated with composite outcome in NYHA I — LA diameter ≥45 mm vs NYHA II | HR 1.56 (95% CI 1.14–2.12) | P = 0.005 | |
| Factors associated with composite outcome in NYHA I — Female sex vs NYHA II | HR 1.61 (95% CI 1.16–2.24) | P = 0.003 | |
| Factors associated with composite outcome in NYHA I — Older age | HR 1.21 per 10 years (95% CI 1.09–1.34) | P < 0.001 | |
| 0.512Hazard ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it