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To the Editor: Dr Maron and colleagues¹ described the data from a multicenter registry collected on more than 500 patients with hypertrophic cardiomyopathy (HCM) who had received an implantable cardioverter-defibrillator for secondary or primary prevention of sudden death. According to that article, patients were diagnosed with HCM based on 2-dimensional echocardiographic evidence of a hypertrophied and nondilated left ventricle in the absence of another cardiac or systemic disease that could account for the magnitude of hypertrophy.

It is not clear if this study included patients with apical HCM. If so, follow-up of this subgroup of patients would be particularly valuable because the medical literature is inconsistent regarding the prognosis of this condition with respect to cardiovascular mortality and sudden cardiac death. For example, initial studies conducted among the Japanese population demonstrated a benign prognosis for apical HCM.² A subsequent study from North America validated this benign prognosis and found no . . . [Full Text of this Article]

Marwan Refaat, MD
rifaatmarwan@hotmail.com
Cardiovascular Institute
University of Pittsburgh Medical Center
Pittsburgh, Pennsylvania

RELATED LETTER

Prognosis of Apical Hypertrophic Cardiomyopathy—Reply
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Implantable Cardioverter-Defibrillators and Prevention of Sudden Cardiac Death in Hypertrophic Cardiomyopathy
Barry J. Maron, Paolo Spirito, Win-Kuang Shen, Tammy S. Haas, Francesco Formisano, Mark S. Link, Andrew E. Epstein, Adrian K. Almquist, James P. Daubert, Thorsten Lawrenz, Giuseppe Boriani, N. A. Mark Estes, III, Stefano Favale, Marco Piccininno, Stephen L. Winters, Massimo Santini, Sandro Betocchi, Fernando Arribas, Mark V. Sherrid, Gianfranco Buja, Christopher Semsarian, and Paolo Bruzzi
JAMA. 2007;298(4):405-412.
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