Outcomes of patients with hypertrophic cardiomyopathy after evaluation at a comprehensive hypertrophic cardiomyopathy center
R Bhatia, A Leslie, L Rushkin, N RezaAbstract
Background
Referral to a comprehensive hypertrophic cardiomyopathy (HCM) center is guideline-recommended to aid in complex disease-related management decisions. There are limited data regarding the outcomes of initial evaluation at a comprehensive HCM center. We sought to explore the care received by patients with HCM as a result of initial referral to a comprehensive United States HCM center.
Methods
Single center retrospective analysis of consecutive HCM probands seen for an initial clinical visit between March 2017 and July 2025. Data regarding clinical characteristics and treatment course through the time of this visit were extracted. Baseline characteristics were reported as median (interquartile range [IQR]) for non-normally distributed continuous variables and frequencies and percentages for categorical variables.
Results
Of 474 probands (median age at first center visit 56.2 years [IQR 44.9, 64.9], 44.9% female, 65.4% self-reported White), 51.1% had obstructive HCM. 21.4% were on no HCM-related medications, and 54.3% were on beta blocker only. As a result of the initial visit, 17.8% underwent dose change of an existing medication for the treatment of HCM, and 13.3% had an HCM-related medication discontinued. Regarding diagnostic testing, 18.8% had an echocardiogram ordered, 47.9% had a stress echocardiogram ordered, 20.9% had a cardiac MRI ordered, and 44.5% had an ambulatory arrhythmia monitor ordered. 11.4% were referred to another specialist for HCM-related care.
Conclusions
In this cohort, additional diagnostic testing with stress echocardiography and ambulatory arrhythmia monitoring was indicated for nearly half of probands seen for an initial visit at a comprehensive HCM center, and nearly a third of probands required a change in HCM-related therapy. Our data suggest that comprehensive HCM centers provide guideline-concordant care that may not be provided outside of these centers.