Document Detail


Natural history of hypertrophic cardiomyopathy: Japanese experience.
MedLine Citation:
PMID:  11433819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVES: Most patients with hypertrophic cardiomyopathy (HCM) remain clinically stable for long periods of time, whereas some patients progress to severe systolic dysfunction. Therefore, the natural history of HCM is largely unknown. METHODS: The present study followed up 59 patients with HCM (32 males, 27 females, mean age 38.6 +/- 13.6 years) for 10 years or more (mean 16.0 +/- 4.7 years) after the initial diagnosis. RESULTS: Eight of 17 patients who showed abnormal Q-waves at the initial examination had lost Q-waves, suggesting remodeling from asymmetric to generalized hypertrophy. The thickness of the interventricular septum showed remarkable changes, increasing by > or = 5 mm in 7 patients and decreasing by > or = 5 mm in 21. These observations indicate that ventricular remodeling occurs in patients with HCM. Follow-up electrocardiography demonstrated new Q-waves in 10 patients and bundle branch blocks or intraventricular conduction disturbances in 13. Left ventricular end-diastolic diameter increased from 41.6 to 48.1 mm, associated with a decrease in fractional shortening from 40.6% to 34.0%. Left ventricular systolic dysfunction, defined as left ventricular end-diastolic diameter > 55 mm or fractional shortening < 25%, developed in 13 patients. These observations indicate that myocardial disease including the conduction system is progressive in patients with HCM and finally deteriorates to systolic dysfunction. Left ventricular outflow obstruction also presented evolutional changes. At the initial study, 23 patients showed systolic anterior motion of the mitral valves. Systolic anterior motion disappeared in 13 patients, reduced in 2, increased in 2, and remained stable in only 6. One patient without systolic anterior motion at the initial study developed new systolic anterior motion. Impaired left ventricular filling increased left atrial diameter from 35.5 to 46.9 mm and atrial fibrillation frequently developed (24 patients). CONCLUSIONS: These findings suggest that HCM is a slowly progressive disease which develops evolutional remodeling of left ventricular hypertrophy and outflow obstruction, eventually progressing to systolic dysfunction with cavity dilation and wall thinning.
Authors:
Y Koga; T Miyamoto; T Ohtsuki; H Toshima
Related Documents :
7172539 - Left ventricular function in patients with mitral valve prolapse. a radionuclide evalua...
7133229 - Non-invasive methods for detection of cardiomyopathy in the course of antineoplastic tr...
11315119 - Factor v leiden and its relation to left ventricular thrombus in acute myocardial infar...
18769309 - Gated myocardial perfusion scintigraphy in children with myocarditis: can it be conside...
15676179 - Safety and tolerability of bosentan in adults with eisenmenger physiology.
12795639 - Prognostic significance of soluble interleukin-2 receptor levels in patients with dilat...
20581759 - Responsiveness of the bournemouth questionnaire in determining minimal clinically impor...
15198879 - Evaluation of von willebrand factor-cleaving protease activity in patients with thrombo...
9285449 - Assessment of olfaction in multiple sclerosis: evidence of dysfunction by olfactory evo...
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of cardiology     Volume:  37 Suppl 1     ISSN:  0914-5087     ISO Abbreviation:  J Cardiol     Publication Date:  2001  
Date Detail:
Created Date:  2001-07-03     Completed Date:  2001-08-02     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8804703     Medline TA:  J Cardiol     Country:  Japan    
Other Details:
Languages:  eng     Pagination:  147-54     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Kurume University Medical Center, Kokubumachi 155-1, Kurume, Fukuoka 839-0863, Japan.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Adult
Cardiomyopathy, Hypertrophic / physiopathology*,  ultrasonography
Disease Progression
Echocardiography
Electrocardiography
Female
Follow-Up Studies
Humans
Hypertrophy, Left Ventricular / physiopathology,  ultrasonography
Male
Middle Aged
Retrospective Studies
Ventricular Function, Left
Ventricular Outflow Obstruction / physiopathology,  ultrasonography

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Molecular etiology of idiopathic cardiomyopathy in Asian populations.
Next Document:  Floppy mitral valve/mitral valve prolapse/mitral valvular regurgitation: effects on the circulation.