Background: It is known that some cases of hypertrophic cardiomyopathy (HCM) exhibit obstruction
of left ventricular outflow tract (LVOT) only when conditions are added such as exercise
or decreasing fluid in left ventricle, so called latent hypertrophic obstructive cardiomyopathy
(HOCM), however, of whom the prognosis compared with HOCM is still unknown. We compared
the natural history and prognosis of latent HOCM and HOCM. Methods: We recruited patients with HCM from April 1, 2010, and all patients who agreed with
the purpose of this study and were able to obtain a consent form were registered in
this study. After enrollment, we performed Dobutamine stressed echocardiography (DSE)
to examine time-velocity integral at LVOT to evaluate potential stenosis, and Gadolinium
contrast cardiac MRI (CMR) to evaluate the degree of fibrosis in myocardium. Results: We registered 96 people by December 31, 2012 and followed for 5 years. 38 (59.4%)
of 64 patients with hypertrophic non-obstructive cardiomyopathy (HNOCM) confirmed
a potential LVOT stenosis by DSE, and 25 (39.1%) patients (12 in latent HCM, 13 in
HNOCM) were judged as a transitional phase to dilated HCM by the CMR, who had poor
prognosis. Conclusion: Latent HOCM was observed in about 60% of HNOCM, and patients with transitional phase
of dilated HCM had poor prognosis.
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