Left Ventricular Assist Device Therapy in Patients with Dilated Phase of Hypertrophic Cardiomyopathy: Comparison with Those of Dilated Cardiomyopathy

Background: Dilated phase of hypertrophic cardiomyopathy (DHCM) characterized by left ventricular systolic dysfunction and cavity dilation has been considered as a disease similar but different from DCM. In left ventricular assist device (LVAD) therapy, there seems to be several clinical features of DHCM compared with those of DCM. Methods: We analyzed data of 32 (DCM = 27 and DHCM = 5) cases implanted with LVAD. Preoperative characteristics and postoperative course were reviewed then, the pathophysiology of DHCM was investigated. Results: Mean age was younger and mean body surface area was larger in DCM group. Time to LVAD implant from a primary diagnosis was longer in DHCM group. Preoperative left ventricular end-diastolic diameter, interventricular septum thickness, ejection fraction, E/E' ratio, systolic pulmonary artery pressure central venous pressure, cardiac index, gender, NYHA class and INTERMACS profiles did not differ between the two groups. Postoperative right heart failure, inhaled nitric oxide use and length of ICU stay were not significantly different between the two groups. Duration of postoperative inotropes support and postoperative intubation time were significantly longer in DHCM group. Conclusion: The present study demonstrated that DHCM patients compared with DCM have longer history of treatment for heart failure before LVAD therapy and need prolonged use of inotropes, ventilator support and ICU stay. Adequate preparations for right-sided heart failure are needed in LVAD therapy for DHCM.