INCIDENCE OF VARIANT HCMP, ECHOCARDIOGRAPHIC CHARACTERISTICS AND CARDIOVASCULAR EVENTS: COMPARATIVE ANALYSIS WITH HCMP

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Objective: Apical HCMP is relatively more prevalent in Asian populations, with an incidence of approximately 25%. However, there is limited knowledge regarding the prevalence of HCMP-associated variant types, their clinical characteristics, and outcomes. Design and method: We conducted a prospective analysis of 156 patients diagnosed with HCMP based on echocardiography results from February 2016 to August 2024. HCMP types were classified according to modified Maron’s classification in which basal concave septal hypertrophy alone (type I), convex septal hypertrophy sparing apex (type II), apical hypertrophy (type III), and diffuse hypertrophy with septum and the anterolateral wall (type IV). Baseline characteristics, echocardiographic values and strain values were analyzed and cardiovascular outcomes were defined as hopitalization due to new onset AF or newly diagnosed stroke, congestive heart failure and mortality. Results: The patients’ average age was 74±13.4 years, and 80 were male and 76 were female. The prevalence of type I, II, III, and IV was 22.4% (n = 35), 14.1% (n = 22), 27.6% (n = 43) and 35.9% (n = 56). In this study we compared Type I and Type II, III, IV groups in terms of echocardiography data, statin value and cardiovascular outcomes. In echocardiographic data, LVM and RWT were notably lower in Type III. Type IV exhibited significantly lower global strain values compared to both Type I and Type III (Type I:Type III:Type IV; -13.7 ± 4.1 vs. -14.3 ± 3.4 vs:-11.2 ± 3.1; p=0.01) In terms of outcome, new onset AF occurred frequently in type II, III, IV groups (Type I vs. type II, III, IV: 4.5±0.4% vs. 10.4±1.73%, p=0.001), and strokes also occurred frequently in Type II, III, IV groups. (Type I vs. Type II, III, IV: 2.2±0.8% vs. 5.1+1.2%, p=0.03). Mortality were not significantly different between two groups. Conclusions: The variant type of HCMP, has been known to have a relatively low mortality rate, however, our study showed that cardiac events such as hospitalization due to new onset AF or stroke are high, so in the future, variant type of HCMP should be treated with clinical caution, and more research is needed.

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