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Prognosis of Apical Hypertrophic CardiomyopathyPrognosis of Apical Hypertrophic Cardiomyopathy

JAMA. 2007;298(17):2006-2006. doi:10.1001/jama.298.17.2006-a
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AUTHOR INFORMATION

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

PROGNOSIS OF APICAL HYPERTROPHIC CARDIOMYOPATHY

To the Editor: Dr Maron and colleagues1 described the data from a multicenter registry collected on more than 500 patients with hypertrophic cardiomyopathy (HCM) who had received an implantable cardioverter-defibrillator for secondary or primary prevention of sudden death. According to that article, patients were diagnosed with HCM based on 2-dimensional echocardiographic evidence of a hypertrophied and nondilated left ventricle in the absence of another cardiac or systemic disease that could account for the magnitude of hypertrophy.

It is not clear if this study included patients with apical HCM. If so, follow-up of this subgroup of patients would be particularly valuable because the medical literature is inconsistent regarding the prognosis of this condition with respect to cardiovascular mortality and sudden cardiac death. For example, initial studies conducted among the Japanese population demonstrated a benign prognosis for apical HCM.2 A subsequent study from North America validated this benign prognosis and found no association with sudden cardiac death.3 However, recent studies have reported patients with apical HCM who had sudden cardiac arrest.4 5 Apical HCM is rare,3 so small study populations and a lack of long-term follow-up might have precluded accurately identifying the rate of adverse clinical events with this variant.

Financial Disclosures: None reported.

References
Maron BJ, Spirito P, Shen WK.  et al.  Implantable cardioverter-defibrillators and prevention of sudden cardiac death in hypertrophic cardiomyopathy.  JAMA. 2007;298(4):405-412
PubMed
Sakamoto T, Amano K, Hada Y.  et al.  Asymmetric apical hypertrophy: ten years experience.  Postgrad Med J. 1986;62(728):567-570
PubMed
Eriksson MJ, Sonnenberg B, Woo A.  et al.  Long-term outcome in patients with apical hypertrophic cardiomyopathy.  J Am Coll Cardiol. 2002;39(4):638-645
PubMed
Abinader EG. Long-term outcome in patients with apical hypertrophic cardiomyopathy.  J Am Coll Cardiol. 2002;40(4):837-838
PubMed
Ridjab D, Koch M, Zabel M, Schultheiss HP, Morguet AJ. Cardiac arrest and ventricular tachycardia in Japanese-type apical hypertrophic cardiomyopathy.  Cardiology. 2007;107(2):81-86
PubMed

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Maron BJ, Spirito P, Shen WK.  et al.  Implantable cardioverter-defibrillators and prevention of sudden cardiac death in hypertrophic cardiomyopathy.  JAMA. 2007;298(4):405-412
PubMed
Sakamoto T, Amano K, Hada Y.  et al.  Asymmetric apical hypertrophy: ten years experience.  Postgrad Med J. 1986;62(728):567-570
PubMed
Eriksson MJ, Sonnenberg B, Woo A.  et al.  Long-term outcome in patients with apical hypertrophic cardiomyopathy.  J Am Coll Cardiol. 2002;39(4):638-645
PubMed
Abinader EG. Long-term outcome in patients with apical hypertrophic cardiomyopathy.  J Am Coll Cardiol. 2002;40(4):837-838
PubMed
Ridjab D, Koch M, Zabel M, Schultheiss HP, Morguet AJ. Cardiac arrest and ventricular tachycardia in Japanese-type apical hypertrophic cardiomyopathy.  Cardiology. 2007;107(2):81-86
PubMed
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