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New York City Conference

Back to 2014 Annual Meeting Abstracts


Left Ventricular Apical Aneurysm And Sudden Cardiac Death In Hypertrophic Cardiomyopathy: A Tunisian Experience
Abdeddayem Haggui, Mohamed Fares Mezni, Aymen Noomen, Imen Hamdi, Houaida Mahfoudhi, Karima Taamallah, Nizar Ben Mansour, Nadhem Hajlaoui,
Wafa Fehri, Habib Haouala.
Military Hospital of Tunis, Tunis, Tunisia.

Objective: Hypertrophic cardiomyopathy (HCM) is an extremely heterogeneous disease. An under recognized and very often missed subgroup within this broad spectrum concerns patients with left ventricular (LV) apical aneurysms in the absence of coronary artery disease. The aim of the present study was the evaluation of apical aneurysm as a new potential risk factor for sudden death in HCM. Methods: We hereby report a retrospective study about 48 patients with HCM followed between 1997 and 2013. Primary endpoint was life-threatening ventricular arrhythmias (LTVA) including SD, resuscitated SD and appropriate implantable cardioverter defibrillator therapy. The mean follow-up period was 5 years. Results: Our population was predominantly young at diagnosis with a mean age of 37 ± 16 years and most of them were male (65%). At initial examination, maximal left ventricular wall thickness was 23 ± 8 mm, a LV outflow gradient > 30 mmHg was present in 23% and an apical aneurysm in 4% of patients. During the follow-up period, 12 patients (25%) had LTVA. The annual rate of LTVA was 5%. In our study, the overall probability of LTVA was significantly greater among patients with apical aneurysm than among those without (p=0.006). However, a multivariate analysis based on the Cox regression didn't identify apical aneurysm as a predictive factor of LTVA in our cohort study. Conclusions: Patients with LV apical aneurysms represent an underappreciated subset in the heterogeneous HCM disease spectrum with important clinical implications. Apical aneurysms in HCM are associated with a potential risk of sudden death and raise novel treatment consideration.


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