From the Guidelines
The life expectancy for patients with Hypertrophic Obstructive Cardiomyopathy (HOCM) diagnosed early is generally favorable, with many patients living a normal or near-normal lifespan, as supported by the most recent study from 2018 1. With early diagnosis and appropriate management, the annual mortality rate is approximately 0.5% per year, as reported in the 2018 study 1. Treatment typically includes beta-blockers (such as metoprolol 25-200 mg daily or bisoprolol 2.5-10 mg daily) or calcium channel blockers (like verapamil 120-480 mg daily) to reduce heart contractility and improve diastolic filling. For patients with significant outflow tract obstruction, disopyramide (100-300 mg twice daily) may be added. Lifestyle modifications are essential, including:
- avoiding dehydration
- extreme exertion
- activities with sudden bursts of effort Regular cardiology follow-up every 6-12 months with echocardiography is recommended to monitor disease progression. Some patients may eventually require more invasive interventions such as septal myectomy or alcohol septal ablation if medical therapy fails. Early diagnosis allows for proper risk stratification, including assessment for sudden cardiac death risk, which may indicate the need for an implantable cardioverter-defibrillator in high-risk patients, significantly improving long-term survival, as noted in the 2011 guideline 1. It is also important to consider the patient's overall health and the presence of other risk factors, such as concomitant coronary artery disease, which can impact survival, as mentioned in the 2011 guideline 1. Overall, with proper management and care, patients with HOCM can lead active and normal lives, as supported by the 2018 study 1.
From the Research
Life Expectancy for Patients with HOCM
When diagnosed early, the life expectancy for patients with Hypertrophic Obstructive Cardiomyopathy (HOCM) can be significantly improved.
- According to a study published in 2024 2, patients with HOCM have a near-normal life expectancy if the disease is diagnosed early and treated according to the guidelines.
- The study also mentions that when optimally treated, HOCM carries a mortality of less than 1% per year.
- Another study from 1999 3 reported a cumulative survival rate of 88% after 10 years and 72% after 20-26 years for patients who underwent surgical treatment for HOCM.
- The yearly disease-related death rate was reduced to 0.6% in this study, indicating a significant improvement in life expectancy with appropriate treatment.
Factors Affecting Life Expectancy
Several factors can affect the life expectancy of patients with HOCM, including:
- The presence of symptoms and the severity of the disease
- The effectiveness of treatment, including pharmacotherapy and surgical or interventional procedures
- The presence of other health conditions or comorbidities
- The patient's overall health and lifestyle
Treatment Options
Various treatment options are available for patients with HOCM, including:
- Pharmacotherapy with beta-blockers or calcium channel antagonists
- Surgical treatment, such as transaortic subvalvular myectomy (TSM)
- Interventional procedures, such as alcohol septal ablation
- Implantation of a pacemaker or implantable cardioverter-defibrillator (ICD)
Importance of Early Diagnosis and Treatment
Early diagnosis and treatment of HOCM are crucial to improve life expectancy and reduce the risk of complications.
- A study from 2019 4 found that conservative treatment was associated with a higher risk of sudden cardiac death (SCD)-related events, while invasive treatment was associated with a higher need for pacemaker implantation.
- Another study from 2005 5 reported a satisfactory clinical effect in 88% of patients who underwent septal ablation for symptomatic HOCM, with significant improvements in symptoms, left atrial size, and septal thickness.