ArticleCardiology journal2026
Warning indicators for heart transplantation requirement at the time of hypertrophic cardiomyopathy diagnosis.
Article in Cardiology journal, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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15 authors.
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Abstract
backgroundTimely identification of hypertrophic cardiomyopathy (HCM) patients who may require a heart transplant (HT) in the future is crucial. Our study aimed to identify predictive factors associated with the need for HT in HCM patients.
methodsAll patients undergoing HT due to HCM in a tertiary HT hospital from 2003 to 2020 were included and compared - matched 1:4 for similar follow-up time since diagnosis - to a control HCM cohort. Patients' clinical and imaging characteristics at HCM diagnosis and longitudinal data were assessed.
results85 patients, 17 who required a HT and 68 HCM control patients from the HCM clinic, were included. At HCM diagnosis, patients who would later require HT had higher NT-proBNP levels (880.5 vs. 86.2 pg/mL), larger left atrium (LA) dimensions (49 vs. 40 mm), and slightly reduced left ventricle (LV) ejection fraction (50 vs. 60%), and showed higher prevalence of atrial fibrillation (AF) (47 vs. 22%). During a median follow-up of 11.6 years, patients subsequently requiring HT developed further worsening functional class and higher incidence of hospital admission for HF and incidence of sustained ventricular tachycardia or appropriate implantable cardioverter-defibrillator (ICD) ther-apy (log-rank p < 0.001 in both). This was accompanied by significant LA dilatation (8 vs. 1 mm, p = 0.037) and worsening LV diastolic function.
conclusionsLeft atrium dilatation, AF, elevated NT-proBNP levels, and lower LV ejection fraction at HCM diagnosis should alert about the potential future need for HT. Progressive LA enlargement and worsening diastolic function during follow-up are warning signs that should prompt referral to a HT center.
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