Abstract 11324: Association of Patient Reported Outcomes With NYHA Class and Functional Capacity in Symptomatic Obstructive Hypertrophic Cardiomyopathy: An Analysis of Spirit-HCM Study

Abstract

Introduction: Patient reported outcomes (PRO) are used to assess quality of life (QOL) in obstructive hypertrophic cardiomyopathy (oHCM). Hypothesis: In symptomatic oHCM patients, we sought to prospectively study the association between various PROs & their association with physician reported New York Heart Association (NYHA) class. Methods: This was a prospective study (ClinicalTrials.gov: NCT03092843) of symptomatic oHCM patients undergoing myectomy (n=173, mean 51 years, 62% men) between 3/2017 & 6/2020. At baseline, we recorded: a) Kansas City Cardiomyopathy Questionnaire (KCCQ) summary score b) Patient-Reported Outcomes Measurement Information System [PROMIS] score c) Duke Activity Status Index [DASI] & d) European QOL score [EQ-5D], in addition to NYHA class, 6-minute walk test (6MWT) distance & peak left ventricular outflow tract gradient (PLVOTG). Results: The median baseline KCCQ summary, PROMIS physical, PROMIS mental, DASI, EQ-5D scores were 50, 37, 44, 25 & 0.61, respectively; 6MWT distance was 366 m. Figure 1 demonstrates highly significant correlations between various PROs, only modest correlations of PROs with 6MWT & PLVOTG. Figure 2 shows that ~1/3rd patients with NYHA class II had worse than median PROs, while ~1/3 rd in NYHA III/IV had PROs better than median. Conclusions: In symptomatic oHCM patients, there is a high internal correlation between various prospectively recorded PROs but a modest correlation with 6MWT & LVOTG. Also, in symptomatic oHCM, NYHA class incompletely characterizes disease severity, and using a more sensitive metric like PROs may help to better identify patients with impaired QOL who will potentially benefit from myectomy.