Francesco Pelliccia1, Vincenzo Pasceri2, Giuseppe Limongelli3, Camillo Autore4, Cristina Basso5, Domenico Corrado6, Massimo Imazio7, Claudio Rapezzi8, Gianfranco Sinagra9, Giuseppe Mercuro10. 1. Department Attilio Reale, Sapienza University, Rome, Italy. Electronic address: f.pelliccia@mclink.it. 2. Interventional Cardiology, San Filippo Neri Hospital, Rome, Italy. 3. Department of Cardiothoracic Sciences, Second University of Naples, Naples, Italy. 4. Cardiology Department, Faculty of Medicine and Psychology, Sapienza University, Rome, Italy. 5. Cardiovascular Pathology, University of Padua Medical School, Padua, Italy. 6. Department of Cardiac, Thoracic, and Vascular Sciences, University of Padua Medical School, Padua, Italy. 7. Department of Medical Sciences, Città della Salute e della Scienza, University of Turin, Turin, Italy. 8. Cardio-thoraco-vascular Department, University Hospital of Bologna, Policlinico S. Orsola-Malpighi, Italy. 9. Cardiovascular Department, "Ospedali Riuniti" and University of Trieste, Trieste, Italy. 10. Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy.
Abstract
BACKGROUND: Prognosis of hypertrophic cardiomyopathy (HCM) is particularly heterogeneous. Patients with nonobstructive HCM (NOCM) are thought to be at relatively low-risk as compared with obstructive HCM (HOCM) with no need of major treatment options. However, available evidence of NOCM comes mainly from tertiary centers where a referral bias is likely to occur. Aim of this study was to perform a systematic review and meta-analysis of the published literature on hypertrophic cardiomyopathy (HCM) in order to outline differences in presenting features and long-term outcome between NOCM and HOCM. METHODS: MEDLINE/Pubmed, EMBASE and Cochrane databases up to December 31, 2016, and reviewed cited references to identify relevant studies were used. The primary endpoints were HCM-related overall mortality rate and yearly rate of cardiac death. Other endpoints were incidences of sudden and congestive heart failure deaths. RESULTS: A total of 20 studies entered the meta-analysis on the long-term outcome of NOCM vs HOCM. They included a total of 7731 patients, 5058 patients with NOCM (65%) and 2673 patients with HOCM (35%). During the follow-up, annual mortality related to HCM averaged 1.55% in NOCM and 1.77% in HOCM (Relative Risk: 0.89, 95% confidence intervals: 0.68 to 1.17, p=0.40). Overall, 5 studies reported significantly higher mortality for HOCM, 3 higher mortality for NOCM, and 12 no significant differences. CONCLUSION: This large study-level meta-analysis shows that long-term mortality of patients with NOCM is not negligible and not significantly different from HOCM.
BACKGROUND: Prognosis of hypertrophic cardiomyopathy (HCM) is particularly heterogeneous. Patients with nonobstructive HCM (NOCM) are thought to be at relatively low-risk as compared with obstructive HCM (HOCM) with no need of major treatment options. However, available evidence of NOCM comes mainly from tertiary centers where a referral bias is likely to occur. Aim of this study was to perform a systematic review and meta-analysis of the published literature on hypertrophic cardiomyopathy (HCM) in order to outline differences in presenting features and long-term outcome between NOCM and HOCM. METHODS: MEDLINE/Pubmed, EMBASE and Cochrane databases up to December 31, 2016, and reviewed cited references to identify relevant studies were used. The primary endpoints were HCM-related overall mortality rate and yearly rate of cardiac death. Other endpoints were incidences of sudden and congestive heart failure deaths. RESULTS: A total of 20 studies entered the meta-analysis on the long-term outcome of NOCM vs HOCM. They included a total of 7731 patients, 5058 patients with NOCM (65%) and 2673 patients with HOCM (35%). During the follow-up, annual mortality related to HCM averaged 1.55% in NOCM and 1.77% in HOCM (Relative Risk: 0.89, 95% confidence intervals: 0.68 to 1.17, p=0.40). Overall, 5 studies reported significantly higher mortality for HOCM, 3 higher mortality for NOCM, and 12 no significant differences. CONCLUSION: This large study-level meta-analysis shows that long-term mortality of patients with NOCM is not negligible and not significantly different from HOCM.
Authors: F Pelliccia; H Seggewiss; F Cecchi; P Calabrò; G Limongelli; O Alfieri; P Ferrazzi; M H Yacoub; I Olivotto Journal: Curr Cardiol Rep Date: 2021-10-01 Impact factor: 2.931