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

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) > or =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 > or = 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.

journal_name

Cardiovasc Ultrasound

journal_title

Cardiovascular ultrasound

authors

Efthimiadis GK,Pliakos C,Pagourelias ED,Parcharidou DG,Giannakoulas G,Kamperidis V,Hadjimiltiades S,Karvounis C,Gavrielidis S,Styliadis IH,Parcharidis G

doi

10.1186/1476-7120-7-37

subject

Has Abstract

pub_date

2009-07-26 00:00:00

pages

issn

1476-7120

pii

1476-7120-7-37

journal_volume

pub_type

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