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01.12.2009 | Research | Ausgabe 1/2009 Open Access

Cardiovascular Ultrasound 1/2009

Identification of high risk patients with hypertrophic cardiomyopathy in a northern Greek population

Zeitschrift:
Cardiovascular Ultrasound > Ausgabe 1/2009
Autoren:
Georgios K Efthimiadis, Christodoulos Pliakos, Efstathios D Pagourelias, Despina G Parcharidou, Georgios Giannakoulas, Vasileios Kamperidis, Stavros Hadjimiltiades, Charalambos Karvounis, Stavros Gavrielidis, Ioannis H Styliadis, Georgios Parcharidis
Wichtige Hinweise

Electronic supplementary material

The online version of this article (doi:10.​1186/​1476-7120-7-37) contains supplementary material, which is available to authorized users.

Competing interests

The authors declare that they have no competing interests.

Authors' contributions

GKE, CP, GG and EDP conceived the original paper, collected the data, reviewed literature and wrote the manuscript. SH, IHS and GP revised the article for important intellectual content and edited the final version. GKE, DP and CK performed the ultrasounds and participated in the analysis and interpretation of data. SG and VK performed the exercise tests and participated in the interpretation of data. All authors read and approved the final manuscript.

Abstract

Background

The percentage of hypertrophic cardiomyopathy (HCM) patients who are in high risk for Sudden Death (SD) constitutes only a minority of all HCM population but the incidence of SD in this subset is high (at least 5% annually). The identification of this small but important proportion of high risk HCM patients has been the clue in the clinical evaluation of these patients.

Methods

Our study cohort consisted from 123 patients with HCM who are currently followed up in our Institution. Five clinical risk factors were assessed: a family history of premature SD, unexplained syncope, Non Sustained Ventricular Tachycardia (NSVT) on 24-h ECG monitoring, Abnormal Blood Pressure Response (ABPR) during upright exercise testing and Maximum left ventricular Wall Thickness (MWT) ≥30 mm. The purpose of our study was the identification of high risk HCM patients coming from Northern Greece.

Results

Fifteen patients (12.2%) of the whole cohort had MWT ≥ 30 mm, 30 patients (24.4%) had an ABPR to exercise, 17 patients (13.8%) had episodes of NSVT in 24-h Holter monitoring, 17 patients (13.8%) suffered from syncope, and 8 patients (6.5%) had a positive family history of premature SD. Data analysis revealed that 74 patients (60.1%) had none risk factor. Twenty four patients (19.5%) had 1 risk factor, 17 patients (13.8%) had 2 risk factors, 4 patients (3.25%) had 3 risk factors, and 4 patients (3.25%) had 4 risk factors, while none patient had 5 risk factors. Twenty five patients (20.3%) had 2 or more risk factors.

Conclusion

This study for the first time confirms that, although a 60% of patients with HCM coming from a regional Greek population are in low risk for SD, a substantial proportion (almost 20%) carries a high risk for SD justifying prophylactic therapy with amiodaron or ICD implantation.
Zusatzmaterial
Authors’ original file for figure 1
12947_2009_284_MOESM1_ESM.pdf
Authors’ original file for figure 2
12947_2009_284_MOESM2_ESM.jpeg
Literatur
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