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Prognosis and prognostic factors in patients with hypertrophic cardiomyopathy in Japan: results from a nationwide study
  1. Ali Nasermoaddeli1,
  2. Katsuyuki Miura1,
  3. Akira Matsumori2,
  4. Yoshiyuki Soyama1,
  5. Yuko Morikawa1,
  6. Akira Kitabatake3,
  7. Yutaka Inaba4,
  8. Hideaki Nakagawa1
  1. 1Department of Epidemiology and Public Health, Kanazawa Medical University, Ishikawa, Japan
  2. 2Department of Cardiovascular Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
  3. 3Department of Cardiovascular Medicine, Hokkaido University Graduate School of Medicine, Sapporo, Japan
  4. 4Department of Epidemiology and Environmental Health, Juntendo University School of Medicine, Tokyo, Japan
  1. Correspondence to:
    Dr K Miura
    Department of Epidemiology and Public Health, Kanazawa Medical University, 1–1 Daigaku, Uchinada, Ishikawa 920–0293, Japan; miura{at}


Objective: To investigate prognosis and prognostic factors in patients with hypertrophic cardiomyopathy (HCM) in Japan.

Design: A nationwide epidemiological study.

Setting: Hospitals selected randomly from among all hospitals in Japan.

Patients: Clinical and epidemiological information for 2155 patients with HCM were collected in 1999.

Main outcome measures: Patients were classified on the basis of baseline prognostic factors. Survival rates up to 5 years were calculated by Cox’s proportional hazard model for 1605 patients.

Results: During the follow-up period, 241 deaths were recorded. The crude 5-year survival rate for the entire cohort was 86% (95% CI 84 to 88), and annual mortality ranged from 2.2% to 3.0%. A higher cardiothoracic ratio on chest x ray (HR 1.61; 95% CI 1.26 to 2.05, with 1 SD (6.2%) increase), a lower left ventricular ejection fraction (HR 1.42; 95% CI 1.20 to 1.69, with 1 SD (13%) decrease) and the presence of left bundle branch block (HR 3.14; 95% CI 1.28 to 7.71) were independently associated with a poorer prognosis, whereas the presence of apical hypertrophy at baseline (HR 0.58; 95%CI 0.36 to 0.92) predicted a better chance of survival.

Conclusions: The nationwide survey of patients with hypertrophic cardiomyopathy yielded important information on its prognosis and prognostic factors. These observations afford, for the first time, a measure of risk stratification in patients with HCM in Japan.

  • AF, atrial fibrillation
  • BMI, body mass index
  • HCM, hypertrophic cardiomyopathy
  • IVS, interventricular septum
  • LBBB, left bundle branch block
  • LVEF, left ventricular ejection fraction
  • LV, left ventricular
  • NYHA, New York Heart Association

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  • Published Online First 3 November 2006

  • Competing interests: None declared.

  • We disclose that there are no other financial, personal or professional relationships with other people or organisations that could be perceived as conflicts of interest, or as potentially influencing or biasing this work.