Nonobstructive Hypertrophic Cardiomyopathy Out of the Shadows: Known from the Beginning but Largely Ignored … Until Now Barry J. Maron, MD, Ethan J.

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Nonobstructive Hypertrophic Cardiomyopathy Out of the Shadows: Known from the Beginning but Largely Ignored … Until Now Barry J. Maron, MD, Ethan J. Rowin, MD, Martin S. Maron, MD, Eugene Braunwald, MD The American Journal of Medicine Volume 130, Issue 2, Pages 119-123 (February 2017) DOI: 10.1016/j.amjmed.2016.09.015 Copyright © 2016 Terms and Conditions

Figure 1 Timeline. Events in hypertrophic cardiomyopathy relevant to developing the principles of nonobstructive vs obstructive disease. HCM = hypertrophic cardiomyopathy. The American Journal of Medicine 2017 130, 119-123DOI: (10.1016/j.amjmed.2016.09.015) Copyright © 2016 Terms and Conditions

Figure 2 Prevalence and risk for advanced heart failure in nonobstructive hypertrophic cardiomyopathy patients (compared with those with rest or provocable obstruction). The proportion of hypertrophic cardiomyopathy patients who develop NYHA functional classes III/IV symptoms, as well as the rate of heart failure progression, is less among nonobstructive hypertrophic cardiomyopathy patients than among those patients with provocable or rest outflow obstruction. NYHA = New York Heart Association functional class; y = year. The American Journal of Medicine 2017 130, 119-123DOI: (10.1016/j.amjmed.2016.09.015) Copyright © 2016 Terms and Conditions

Figure 3 Evolution in understanding the natural history profile in hypertrophic cardiomyopathy. (Left) The present data demonstrate that the vast majority of patients with hypertrophic cardiomyopathy (HCM) do not develop severe progressive heart failure to NYHA functional classes III/IV or require consideration for transplantation (ie, the missing sector). (Right) With the missing sector of the pie inserted, the overall clinical course of HCM is completed, with almost 40% of the cohort represented by stable nonobstructive disease in classes I/II. ASA = alcohol septal ablation; NYHA = New York Heart Association functional class. The American Journal of Medicine 2017 130, 119-123DOI: (10.1016/j.amjmed.2016.09.015) Copyright © 2016 Terms and Conditions