P6160Long term prognosis of intramural course of coronary arteries in patients with hypertrophic cardiomyopathy assessed by coronary CT angiography

Abstract

Abstract Background The prognostic value of an intramural course of the coronary arteries detected by coronary CTA in patients with hypertrophic cardiomyopathy (HCM) is not well-known. Purpose To evaluate in patients with HCM, who were referred for coronary computed tomography angiography (CTA), whether an intramural course of a coronary artery is associated with a worse outcome compared to HCM patients without an intramural course of the coronary arteries. Methods The study population consisted of 92 patients with HCM who were referred for coronary CTA and who did not have obstructive CAD. During follow-up, the occurrence of unstable angina pectoris that required hospitalization, myocardial infarction, and all-cause mortality was evaluated (i.e. adverse cardiac events). Results Using coronary CTA, 57 patients (62%) had an intramural course of coronary arteries. Patients with HCM were followed over 5.5±3.5 years. The composite of adverse cardiac events occurred in 17/57 (29.8%) patients with, and 11 out of 35 (31.4%) patients without intramural course (P=0.87). The event rate of unstable angina pectoris requiring hospitalization (28.1% vs. 22.9%), myocardial infarction (1.8% vs. 8.6%), and all case mortality (0.0% vs. 0.0%) was similar in patients with and without an intramural course. Conclusion Intramural course of coronary arteries in patients with HCM was frequently observed by coronary CTA, but it was not associated with worse cardiovascular clinical outcome.