Clinical characteristics and outcome of hypertrophic cardiomyopathy in the Saudi population – A single cardiac center experience

Abstract

Introduction: Hypertrophic Cardiomyopathy (HCM), a relatively uncommon entity, is the most common form of genetic cardiovascular disorders. It is the most common cause of sudden death in the young and also heart failure which can occur at any age. While HCM is a well-described global disorder, there is paucity of data on this important clinical entity in Saudi Arabia. Therefore, the aim of this study was to explore the clinical characteristics and outcome of HCM in a Saudi population attending King Abdul Aziz Cardiac Center (KACC), Riyadh. Methodology: We retrospectively collected electronic echocardiographic data in adult HCM patients at KACC, Riyadh, between January 1st 2002 and December 31st 2016 (Xcelera™). Cases of secondary left ventricular hypertrophy were excluded. In addition, demographic, anthropometric, comorbidities and outcome data was also recorded (Apollo Lx). Data was analysed using JMP version 7.1 (SAS for Windows). Results: Data were available for 77 patients, mean age 40 ± 17 years, 63.6% males. Commonest comorbidities included hypertensive (23.5%), diabetes mellitus (15.6%), coronary artery disease (15.6%) stroke (10.4%), atrial fibrillation (13 %) and ventricular tachycardia (5%). Half of the population had associated mitral regurgitation. Nine percent of patients had a history of syncope and 13% family history of sudden cardiac death. There was a significant interaction between age and HCM morphology (p < 0.001); reverse curvature septum was the commonest morphology (47%). Automated defibrillator was implanted in 28.5%. Conclusion: The HCM population in our Center is young, predominantly male with largely reverse curvatum morphology and mitral regurgitation observed in half of the cases. A country-wide registry is warranted to further explore HCM phenotypes in the Saudi population.