Abstract 13918: Prognostic Implication of Mitral Valve Disease in Patients With Hypertrophic Cardiomyopathy

Abstract

Introduction: Hypertrophic cardiomyopathy (HCM) is a genetic disorder affecting not only the myocardium, but also the mitral valve (MV) and its apparatus. Hypothesis: MV disease would have a prognostic implication in patients with HCM. Methods: We reviewed MV function and structure in the indexed echocardiograms of 1,185 HCM patients (60 ±14 years, men 67%) who were included in a single-center longitudinal HCM registry. Patients were classified as obstructive (n=104) or non-obstructive (n=1,081) HCM. Clinical outcomes were defined as a composite of cardiovascular death, heart failure hospitalization, MV surgery or septal myectomy, and heart transplantation. Results: Overall, 278 patients (23.5%) showed at least mild mitral regurgitation (MR) on their indexed echocardiogram (Figure 1-1). MR, systolic anterior motion (SAM), and mitral annular calcification (MAC) were more prevalent in patients with obstructive HCM than in those with non-obstructive HCM. During a mean of 7.0 ± 4.0 years’ follow-up, Kaplan-Meier plots revealed that patients with MR showed poorer clinical outcomes (21.6% vs.7.3%, log-rank p < 0.001) than those without MR (Figure 1-2). A multivariate Cox model revealed that MR was independently associated with clinical outcome (hazard ratio 1.57, 95% confidence interval 1.04-2.35, p=0.030) along with female sex, chronic kidney disease, atrial fibrillation, obstructive type HCM, and diastolic dysfunction. Conclusions: MV disease is not uncommon in patients with HCM. MR, SAM, and MAC are more prevalent in patients with obstructive HCM. The presence of MR is associated with a poor prognosis in patients with HCM.