Résumé :
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[BDSP. Notice produite par INIST R0xExYcG. Diffusion soumise à autorisation]. Background A previous study suggested that severe left-ventricular hypertrophy (maximum wall thickness >=30 mm) in patients with hypertrophic cardiomyopathy is associated with a risk of sudden cardiac death sufficient to warrant consideration for implantation of a cardioverter defibrillator (ICD). However, the prognostic significance of left-ventricular hypertrophy in relation to other clinical risk factors is poorly characterised. Methods We studied 630 patients consecutively referred to one hospital in London, UK (mean age 37 years [SD 16] ; 382 male ; mean follow-up 59 months). Patients underwent two-dimensional and doppler echocardiography, upright exercise testing, and Holter monitoring. Findings 39 patients died suddenly or had an appropriate ICD discharge ; nine died from progressive heart failure ; 11 from other cardiovascular causes and 23 from non-cardiac causes. There was a trend towards higher probability of sudden death or ICD discharge with increasing wall thickness (p=0.029, relative risk per 5 mm increment 1.31 [95% CI 1.03-1.66]). Of the 39 patients who died suddenly or had an ICD discharge, ten had a wall thickness of 30 mm or more. Patients with wall thickness of 30 mm or more had higher probability of sudden death or ICD discharge than patients with wall thickness less than 30 mm (p=0.049,2.07 [1.00-4.25]. (...)
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