Percutaneous coronary intervention in patients with hypertrophic cardiomyopathy and coronary artery disease

Abstract

Background Coronary artery disease and left ventricular outflow tract obstruction may overlap in symptoms in patients with hypertrophic cardiomyopathy. It has not been clear if coronary revascularization relieves exertional symptoms in patients with hypertrophic cardiomyopathy. Methods We reviewed 156 patients with hypertrophic cardiomyopathy who underwent percutaneous coronary intervention at Anzhen Hospital from 2009 to 2019. Improvement in symptoms after the percutaneous coronary intervention was investigated. Results The mean age was 60.8 ± 9.8 years, and 116 (74.4%) were men. The main symptoms of the patients were chest tightness in 115 (73.7%), chest pain in 88 (56.4%), dyspnea in 50 (32.1%), palpitation in 22 (14.1%), and presyncope/syncope in 12 (7.7%). At rest, the systolic anterior motion of the mitral valve was observed in only 36 patients. Among the 156 patients, 64 had single-vessel disease, 46 had two-vessel diseases, and the other 46 had three-vessel diseases. There was no early mortality in the present cohort. After the coronary intervention, there were significant improvements in symptoms including chest tightness (6.4%), chest pain (1.3%), dyspnea (2.6%), and palpitation (8.3%). In 93 patients with follow-up data, the overall survival was 77% at 10 years and the survival free from intervention was 60% at 10 years. Conclusions In patients with hypertrophic cardiomyopathy, coronary artery disease can be an important cause of symptoms and should be screened. Percutaneous coronary intervention is safe and effective for coronary revascularization. Cardiac symptoms can be significantly relieved and long-term outcomes are favorable.