Table 1.
Demographic and clinical characteristics of patients with hypertrophic obstructive cardiomyopathy stratified by BMI
| Variable | Overall | Normal | Overweight | Obesity | p value |
|---|---|---|---|---|---|
| BMI < 23 kg/m2 | BMI 23–27.5 kg/m2 | BMI ≥ 27.5 kg/m2 | |||
| n | 423 | 98 | 212 | 113 | |
| Male, n (%) | 249 (58.9%) | 42 (42.9%) | 131 (61.8%) | 76 (67.3%) | 0.001 |
| Age (years) | 48.2 ± 12.2 | 45.7 ± 14.5 | 48.6 ± 11.8 | 49.6 ± 10.5 | 0.052 |
| BMI (kg/m2) | 25.4 ± 3.4 | 21.0 ± 1.7 | 25.3 ± 1.3 | 29.6 ± 1.9 | <0.001 |
| BSA (m2) | 1.76 ± 0.20 | 1.57 ± 0.14 | 1.76 ± 0.16 | 1.92 ± 0.15 | <0.001 |
| Systolic blood pressure (mm Hg) | 118.7 ± 16.8 | 113.1 ± 16.3 | 119.1 ± 16.8 | 122.8 ± 16.2 | <0.001 |
| Diastolic blood pressure (mm Hg) | 72.5 ± 10.3 | 68.0 ± 10.0 | 73.4 ± 10.1 | 74.6 ± 9.9 | <0.001 |
| Heart rate (beats/min) | 71.8 ± 10.8 | 72.7 ± 11.2 | 71.4 ± 10.2 | 71.7 ± 11.5 | 0.616 |
| NYHA functional class III or IV, n (%) | 145 (34.3%) | 34 (34.7%) | 72 (34%) | 39 (34.5%) | 0.990 |
| Chest pain, n (%) | 195 (46.1%) | 46 (46.9%) | 91 (42.9%) | 58 (51.3%) | 0.345 |
| Palpitation, n (%) | 138 (32.6%) | 32 (32.7%) | 65 (30.7%) | 41 (36.3%) | 0.589 |
| Family history of HCM, n (%) | 56 (13.2%) | 14 (14.3%) | 29 (13.7%) | 13 (11.5%) | 0.808 |
| Atrial fibrillation, n (%) | 57 (13.5%) | 14 (14.3%) | 21 (9.9%) | 22 (19.5%) | 0.054 |
| Risk factor for SCD | |||||
| Family history of SCD, n (%) | 22 (5.2%) | 7 (7.1%) | 10 (4.7%) | 5 (4.4%) | 0.610 |
| Syncope, n (%) | 109 (25.8%) | 32 (32.7%) | 60 (28.3%) | 17 (15.0%) | 0.007 |
| Maximum wall thickness ≥ 30 mm, n (%) | 74 (17.5%) | 15 (15.3%) | 41 (19.3%) | 18 ( 15.9%) | 0.601 |
| Resting LVOTPG ≥ 30 mm Hg, n (%) | 355 (83.9%) | 86 (87.8%) | 177 (83.5%) | 92 (81.4%) | 0.444 |
| Nonsustained VTa, n (%) | 42 (19.7%) | 11 (23.4%) | 22 (19.1%) | 9 (17.6%) | 0.753 |
| Traditional cardiovascular risk factor | |||||
| Hypertension, n (%) | 140 (33.1%) | 7 (7.1%) | 76 (35.8%) | 57 (50.4%) | <0.001 |
| Diabetes mellitus, n (%) | 27 (6.4%) | 0 (0%) | 11 (5.2%) | 16 (14.2%) | <0.001 |
| Dyslipidemia, n (%) | 150 (35.5%) | 22 (22.4%) | 73 (34.4%) | 55 (48.7%) | <0.001 |
| Current smokers, n (%) | 155 (36.6%) | 19 (19.4%) | 83 (39.2%) | 53 (46.9%) | <0.001 |
| Laboratory examination | |||||
| eGFR (mL/min/1.73 m2) | 98.0 ± 20.0 | 99.8 ± 17.3 | 98.6 ± 22.6 | 95.3 ± 16.7 | 0.212 |
| Serum uric acid (μmol/L) | 366.7 ± 93.3 | 339.5 ± 81.0 | 368.6 ± 88.6 | 386.5 ± 106.2 | 0.001 |
| HbA1c (%) | 5.6 ± 0.7 | 5.5 ± 0.4 | 5.6 ± 0.6 | 5.8 ± 1.1 | 0.029 |
| hs-CRP (mg/L) | 1.06 (0.51–1.98) | 0.65 (0.15–1.45) | 1.10 (0.60–1.97) | 1.25 (0.79–2.22) | <0.001 |
| Total cholesterol (mmol/L) | 4.51 ± 1.00 | 4.47 ± 0.90 | 4.51 ± 0.93 | 4.56 ± 1.18 | 0.794 |
| Triglycerides (mmol/L) | 1.59 ± 1.07 | 1.24 ± 0.56 | 1.61 ± 1.25 | 1.86 ± 0.96 | <0.001 |
| HDL-C (mmol/L) | 1.14 ± 0.31 | 1.27 ± 0.34 | 1.13 ± 0.30 | 1.03 ± 0.27 | <0.001 |
| LDL-C (mmol/L) | 2.85 ± 0.86 | 2.77 ± 0.73 | 2.85 ± 0.84 | 2.90 ± 0.99 | 0.502 |
| cTNI (ng/mL) | 0.022 (0.009–0.042) | 0.019 (0.010–0.048) | 0.022 (0.007–0.042) | 0.022 (0.013–0.041) | 0.907 |
| NT-proBNP (pmol/L) | 1183.0 (635.5–2270.6) | 1488.0 (811.4–2597.5) | 1292.3 (734.7–2344.6) | 968.9 (415.4–1717.7) | 0.004 |
| Log NT-proBNP | 3.04 ± 0.42 | 3.15 ± 0.37 | 3.05 ± 0.42 | 2.93 ± 0.46 | 0.002 |
| Medications | |||||
| Beta-blockers, n (%) | 318 (75.2) | 75 (76.5) | 159 (75.0) | 84 (74.3) | 0.931 |
| Nondihydropyridine CCB, n (%) | 68 (16.1) | 11 (11.2) | 37 (17.5) | 20 (17.7) | 0.328 |
| Amiodarone, n (%) | 11 (2.6) | 5 (5.1) | 3 (1.4) | 3 (2.7) | 0.165 |
| ACEI/ARB, n (%) | 48 (11.3) | 5 (5.1) | 23 (10.8) | 20 (17.7) | 0.015 |
| Statins, n (%) | 50 (11.8) | 8 (8.2) | 29 (13.7) | 13 (11.5) | 0.373 |
| Echocardiography | |||||
| Systolic anterior motion, n (%) | 384 (90.8) | 90 (91.8) | 195 (92.0) | 99 (87.6) | 0.396 |
| Moderate or severe mitral regurgitation, n (%) | 25 (5.9) | 10 (10.2) | 14 (6.6) | 1 (0.9) | 0.014 |
| LVOTPG at rest (mm Hg) | 70.3 ± 36.3 | 75.3 ± 38.8 | 70.6 ± 36.7 | 65.5 ± 32.7 | 0.153 |
| LVOTPG after provocationb (mm Hg) | 78.6 ± 30.8 | 80.2 ± 43.1 | 81.6 ± 26.8 | 72.7 ± 28.5 | 0.430 |
| Cardiovascular magnetic resonance | |||||
| Left atrial diameter (mm) | 42.5 ± 8.3 | 40.2 ± 9.7 | 42.0 ± 7.7 | 45.4 ± 7.3 | <0.001 |
| Left atrial diameter index (mm/m2) | 24.4 ± 5.4 | 25.9 ± 6.9 | 24.1 ± 4.9 | 23.8 ± 4.4 | 0.040 |
| LV end-diastole diameter (mm) | 46.0 ± 4.9 | 44.9 ± 5.3 | 46.2 ± 4.6 | 46.6 ± 4.9 | 0.025 |
| Maximum wall thickness (mm) | 24.5 ± 5.3 | 24.5 ± 5.1 | 24.4 ± 5.6 | 24.7 ± 4.9 | 0.915 |
| LV ejection fraction (%) | 68.4 ± 8.0 | 67.8 ± 8.7 | 68.5 ± 8.0 | 68.6 ± 7.6 | 0.722 |
| Cardiac output (L/min) | 5.9 ± 1.7 | 5.4 ± 1.4 | 5.9 ± 1.8 | 6.4 ± 1.7 | <0.001 |
| LV end-systole volume index (mL/m2) | 23.5 ± 9.8 | 24.9 ± 11.3 | 23.1 ± 9.0 | 23.2 ± 10.0 | 0.290 |
| LV end-diastole volume index (mL/m2) | 72.2 ± 16.6 | 73.9 ± 17.2 | 72.2 ± 16.9 | 70.8 ± 15.3 | 0.409 |
| Stroke volume index (mL/m2) | 49.0 ± 11.1 | 49.6 ± 10.9 | 49.1 ± 11.8 | 48.4 ± 10.1 | 0.794 |
| Cardiac index (L/m2) | 3.37 ± 0.88 | 3.43 ± 0.87 | 3.37 ± 0.92 | 3.31 ± 0.81 | 0.630 |
| LV mass index (g/m2) | 89.9 ± 36.2 | 89.7 ± 38.0 | 88.8 ± 35.6 | 92.4 ± 36.1 | 0.696 |
Data are expressed as mean ± SD, number (percentage), or median (interquartile range).
BMI: body mass index, BSA: body surface area, NYHA: New York Heart Association, HCM: hypertrophic cardiomyopathy, SCD: sudden cardiac death, LVOTPG: left ventricular outflow tract pressure gradient, VT: ventricular tachycardia, eGFR: estimated glomerular filtration rate, HbA1c: glycated hemoglobin, hs-CRP: high-sensitivity C-reactive protein, HDL-C: high-density lipoprotein cholesterol, LDL-C: low-density lipoprotein cholesterol, NT-proBNP: N-terminal pro-B-type natriuretic peptide, CCB: calcium channel blocker, ACEI: angiotensin converting enzyme inhibitor, ARB: angiotensin receptor blocker, LV: left ventricular.
a
Ambulatory 24-h Holter monitoring data were available in 213 of the 423 participants.
b
Provoking LVOTPG data were obtained in 103 patients.