CardiomyopathyUnusual Features of Apical Hypertrophic Cardiomyopathy
Section snippets
Methods
Over a 5-year period from 2003 to 2008, 32 consecutive patients with apical HC were retrospectively identified in the cardiology department of a teaching hospital without a specialized HC clinic. The study was approved by the Human Ethics Committee of the Central Sydney Area Health Service (Concord Hospital Division). Presenting symptoms and associated clinical features were characterized, and cardiovascular morbidity and mortality were determined on follow-up. Electrocardiograms were examined
Results
The clinical characteristics of our patients are listed in Table 1. Our cohort was elderly, with a mean age of 71 years. The mean follow-up of the patients was 4 ± 3 years (range 1 to 26), and 2 patients were lost to follow-up. The patients were unrelated apart from 2 who were related as father and daughter. Twenty-two patients had hypertension at the time of presentation. There were 6 deaths in the cohort, including 2 after atrial fibrillation–related hemiplegic strokes and 2 from progressive
Discussion
To our knowledge, this is the first and largest case series characterizing apical HC and its morbidity in an elderly non-Japanese population. In a general hospital without a referral bias to a specialized HC clinic, apical HC appears to be a disease of the elderly that carries an adverse prognosis, especially in the presence of atrial fibrillation. The diagnosis, when not carefully considered, can be missed. Apical HC in the elderly has unique cardiovascular characteristics, such as late
References (22)
- et al.
Long-term outcome in patients with apical hypertrophic cardiomyopathy
J Am Coll Cardiol
(2002) - et al.
Apical hypertrophic cardiomyopathy: clinical follow-up and diagnostic correlates
J Am Coll Cardiol
(1990) - et al.
Comparison of prevalence of apical hypertrophic cardiomyopathy in Japan and the United States
Am J Cardiol
(2003) - et al.
Isolated noncompaction of the ventricular myocardium in adults
Am J Cardiol
(2004) - et al.
Giant negative T-wave inversion as a manifestation of asymmetric apical hypertrophy (AAH) of the left ventricle: echocardiographic and ultrasono-cardiotomographic study
Jpn Heart J
(1976) - et al.
Hypertrophic non-obstructive cardiomyopathy with giant negative T-waves (apical hypertrophy): ventriculographic and echocardiographic features in 30 patients
Am J Cardiol
(1979) - et al.
Detection of apical hypertrophic cardiomyopathy by cardiovascular magnetic resonance in patients with non-diagnostic echocardiography
Heart
(2004) - et al.
Apical hypertrophic cardiomyopathy diagnosed by cardiac magnetic resonance imaging
Tex Heart Inst J
(2006) - et al.
Apical hypertrophic cardiomyopathy
Circulation
(1998) - et al.
Long-term evaluation of patients with apical hypertrophic cardiomyopathy
Eur Heart J
(1995)