Differential diagnosis and prediction of progression of hypertrophic non-obstructive cardiomyopathy

Aim

To develop an algorithm of differential diagnosis between hypertrophic non-obstructive cardiomyopathy (HNCM) and myocardial hypertrophy in arterial hypertension (AH) and a model to predict progression of HNCM.

Material and methods

We evaluated the clinical data, ECG, echocardiography, daily ECG monitoring and heart rate variability in 102 patients with HNCM and 64 patients with AH/coronary heart disease and secondary myocardial hypertrophy. The duration of follow-up of patients with HNCM averaged 11.0 ± 5.7 years (1 to 29 years). We used step-by-step discriminant analysis to construct mathematical models that were validated in patients with HNCM or AH who were not included in the mathematical model calculation groups.

Results

We developed two algorithms to differentiate HNCM from secondary myocardial hypertrophy and to predict progression of HNCM. Both algorithms are based on clinical (the severity of chronic heart failure, the duration of the disease, angina pectoris, rhythm disorders, etc.) and other data (repolarization disorders and amplitude signs of right ventricular hypertrophy on ECG, left ventricular volumes, the excursion of the walls of the right and left ventricles, dilation of left atrium, etc.). The sensitivity of the two models was 79.7% and 78.6%, respectively, and specificity was 77.2% and 58.3%.

Conclusion

Two-step algorithm was developed to differentiate HNCM from secondary myocardial hypertrophy and to predict progression of HNCM.

Key words

Hypertrophic non-obstructive cardiomyopathy, differential diagnosis, prediction of progression.