Palpitation was associated with clinical outcomes in patients with hypertrophic cardiomyopathy

Abstract

Hypertrophic cardiomyopathy (HCM) is a common genetic heart disease with diversified clinical presentation and it is important to identify new predictors of clinical outcomes and survival in HCM patients. In our study, 206 HCM patients were compared with respect to major adverse cardiovascular and cerebrovascular events. By multivariable logistic analysis, we determined that palpitation, together with chronic heart failure (CHF) > 1 year, was an independent predictor of major adverse cardiovascular and cerebral events (MACCE) in HCM patients (OR 3.24, 95% CI 1.60-6.57, P = 0.001). Specially, palpitation was related to higher prevalence of rehospitalization (OR 3.86, 95% CI 2.08-7.08, P < 0.001), cardiac death (OR 2.96, 95% CI 1.05-8.32, P = 0.04) and heart failure exacerbation (OR 4.07, 95% CI 2.04-8.13, P < 0.001). However, patients presented with palpitation did not show a significantly different cardiac phenotype and function. Finally, palpitation predicted a poor prognosis in HCM patients without atrial fibrillation by utilizing Kaplan-Meier analysis (P = 0.041). In conclusion, palpitation could be a new predictor of clinical outcomes and overall survival in HCM patients.

Figure 1

The survival analysis of palpitation in HCM patients with or without AF. (A) The HCM cohorts with AF showed no significant difference in overall survival. (B) For HCM patients without AF, patients with palpitation had a poor survival that without palpitation. AF atrial fibrillation.