Hypertrophic cardiomyopathy with aortic dilation: a novel observation

Eur Heart J Cardiovasc Imaging. 2017 Dec 1;18(12):1398-1403. doi: 10.1093/ehjci/jew292.

Abstract

Aims: Our goal was to identify the prevalence of aortic dilation in patients with hypertrophic cardiomyopathy (HCM), the most prevalent (0.2%) heritable, genetic cardiovascular disease. Aortic dilation also represents a spectrum of familial inheritance. However, data regarding the prevalence of aortic dilation in HCM patients is lacking.

Methods and results: This is an observational retrospective study of all patients referred to our HCM centre. Aortic dilation was defined based on recent American Society of Echocardiography and European Association of Cardiovascular Imaging published guidelines. Of the 201 HCM patients seen between Jan. 1, 2011 and March 31, 2014, 18 (9.0%) met the definition of aortic dilation. Mean age was 56.3 ± 9.3 years, 77.8% were male, mean ascending aorta diameter was 4.0 ± 0.4 cm in males and 3.8 ± 0.2 cm in females, mean sinuses of Valsalva diameter was 4.2 ± 0.2 cm in males and 3.8 ± 0.4 cm in females, and 13 (72.2%) had left ventricular outflow tract obstruction. HCM patients with dilated aorta were more likely males, less likely hypertensive and had larger left ventricle diameter and more aortic valve regurgitation; remaining characteristics were similar.

Conclusion: We report a novel observation with 9.0% prevalance of dilated aorta in HCM patients. Further studies are needed to help define the genetic and pathophysiologic basis as well as the clinical implications of this association in a larger group of HCM patients.

Keywords: aorta; genetics; hypertrophic cardiomyopathy.

Publication types

  • Comparative Study
  • Observational Study

MeSH terms

  • Aged
  • Aortic Valve Insufficiency / diagnostic imaging*
  • Aortic Valve Insufficiency / epidemiology*
  • Aortic Valve Insufficiency / physiopathology
  • Cardiomyopathy, Hypertrophic / diagnostic imaging*
  • Cardiomyopathy, Hypertrophic / epidemiology*
  • Cardiomyopathy, Hypertrophic / physiopathology
  • Cohort Studies
  • Comorbidity
  • Death, Sudden, Cardiac*
  • Echocardiography / methods
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Risk Assessment
  • Severity of Illness Index
  • Survival Analysis
  • Tertiary Care Centers
  • Tomography, X-Ray Computed / methods