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• W2059083572 abstract "Sudden unexpected death can be the first clinical manifestation of hypertrophic cardiomyopathy and is the most devastating feature of the natural history of the disease. Left ventricular hypertrophy appears to be an important determinant of many clinical features of hypertrophic cardiomyopathy, but the relation between its magnitude and the occurrence of sudden cardiac death has not been clearly defined. In this study, the magnitude of hypertrophy was assessed with two-dimensional echocardiography in 29 asymptomatic or mildly sym ptomadc patients with hypertrophic cardiomyopathy who subsequently died suddenly or experienced cardiac arrest with documentw ventricular fibrillation. Findings were compared with those obtained in a control group of 95 patients of similar age and symptomatic state. Maximal left ventricular wall thickness was significantly greater in patients with sudden death (26±7 mm) than in control patients (21 ± 5 mm, p < 0.001). Left ventricular wall thickness index, a quantitative expression of the overall extent of hypertrophy, was also greater in patients with sudden death (76 ± 20 mm) than in surviving control patients (62 ± 13 mm, p < 0.001). Particularly marked and diffuse hypertrophy, with maximal wall thickness ≥30 mm or wall thickness ≥25 mm in two or more of the four segments into which the left ventricle had been divided, was eight times more common in patients with sudden death (11 [38%] of 29) than in control patients (5 [5%] of 95, p < 0.001). The prevalence of mild and localized hypertrophy, with maximal wall thickness ≤517 mm involving only one segment, was similar in patients with sudden death (4 [14%] of 29) and in control patients (23 [24%) of 95, p > 0.05); however, of the four patients with sudden death and mild hypertrophy, only one was an adult; three were preadolescent children whose hypertrophy would have been considered to be more substantial if corrected for body surface area. It is concluded that most asymptomatic or mildly symptomatic patients with hypertrophic cardiomyopathy who die suddenly have marked and diffuse left ventricular hypertrophy, and that a relation exists between the extent of hypertrophy and the occurrence of sudden and unexpected death in this disease. Sudden cardiac death is uncommon in asymptomatic or mildly symptomatic adult patients with hypertrophic cardiomyopathy and relatively mild left ventricular hypertrophy." @default.
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• W2059083572 title "Relation between extent of left ventricular hypertrophy and occurrence of sudden cardiac death in hypertrophic cardiomyopathy" @default.
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• W2059083572 doi "https://doi.org/10.1016/0735-1097(90)92820-r" @default.
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