Prognostic Impact of Left Ventricular Apical Aneurysm Identified by Echocardiography in Hypertrophic Cardiomyopathy ― A Multicenter Retrospective Study in Japan ―
Abstract
BACKGROUND: This study evaluated the prognostic impact of left ventricular (LV) apical aneurysm identified by transthoracic echocardiography (TTE) in a Japanese cohort with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS: We retrospectively enrolled 369 consecutive HCM patients from 2 centers (2016-2023). LV apical aneurysm was defined on TTE as a discrete, thin-walled dyskinetic/akinetic apical outpouching with a wide neck. Primary outcomes were all-cause death and cardiovascular (CV) death. Secondary outcomes were hospitalization for worsening heart failure, systemic embolism, sustained ventricular tachycardia (VT), and sudden cardiac death (SCD)-equivalent events (resuscitated cardiac arrest or appropriate implantable cardioverter defibrillator therapy). LV apical aneurysm was present in 47 of 369 patients (12.7%). There were no significant between-group differences in all-cause death (log-rank P=0.162) or CV death (P=0.103). Patients with LV apical aneurysm more frequently had baseline sustained VT and SCD-equivalent events; however, Kaplan-Meier analyses indicated no significant differences between groups in incident sustained VT and SCD-equivalent events after enrollment. In multivariable Cox models, age, B-type natriuretic peptide (BNP), and SCD-equivalent events were independently associated with all-cause death; BNP and SCD-equivalent events were independently associated with CV death. CONCLUSIONS: In this cohort, echocardiography-identified LV apical aneurysm was associated with a greater burden of baseline arrhythmic events, but not higher mortality. TTE provides a practical means of identifying this phenotype. BNP and SCD-equivalent events were more closely associated with mortality.
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BibTeX
@article{komatsu2026prognostic,
title = {{Prognostic Impact of Left Ventricular Apical Aneurysm Identified by Echocardiography in Hypertrophic Cardiomyopathy ― A Multicenter Retrospective Study in Japan ―}},
author = {Junya Komatsu and Naoki Arima and Yuri Ochi and Toru Kubo and Yu-ki Nishimura and Hayato Hosoda and Ryu-ichiro Imai and Yoko Nakaoka and Shinji Mito and Shu-ichi Seki and Sho-ichi Kubokawa and Hiroaki Kitaoka and Kazuya Kawai and Naohisa Hamashige and Yoshinori L. Doi},
journal = {Circulation Journal},
year = {2026},
month = oct,
doi = {10.1253/circj.cj-26-0311},
url = {https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0311/_article},
note = {CC BY-NC-ND},
}
RIS
TY - JOUR
TI - Prognostic Impact of Left Ventricular Apical Aneurysm Identified by Echocardiography in Hypertrophic Cardiomyopathy ― A Multicenter Retrospective Study in Japan ―
AU - Junya Komatsu
AU - Naoki Arima
AU - Yuri Ochi
AU - Toru Kubo
AU - Yu-ki Nishimura
AU - Hayato Hosoda
AU - Ryu-ichiro Imai
AU - Yoko Nakaoka
AU - Shinji Mito
AU - Shu-ichi Seki
AU - Sho-ichi Kubokawa
AU - Hiroaki Kitaoka
AU - Kazuya Kawai
AU - Naohisa Hamashige
AU - Yoshinori L. Doi
PY - 2026
DA - 2026/10/23
JO - Circulation Journal
DO - 10.1253/circj.cj-26-0311
UR - https://www.jstage.jst.go.jp/article/circj/90/11/90_CJ-26-0311/_article
AB - BACKGROUND: This study evaluated the prognostic impact of left ventricular (LV) apical aneurysm identified by transthoracic echocardiography (TTE) in a Japanese cohort with hypertrophic cardiomyopathy (HCM). METHODS AND RESULTS: We retrospectively enrolled 369 consecutive HCM patients from 2 centers (2016-2023). LV apical aneurysm was defined on TTE as a discrete, thin-walled dyskinetic/akinetic apical outpouching with a wide neck. Primary outcomes were all-cause death and cardiovascular (CV) death. Secondary outcomes were hospitalization for worsening heart failure, systemic embolism, sustained ventricular tachycardia (VT), and sudden cardiac death (SCD)-equivalent events (resuscitated cardiac arrest or appropriate implantable cardioverter defibrillator therapy). LV apical aneurysm was present in 47 of 369 patients (12.7%). There were no significant between-group differences in all-cause death (log-rank P=0.162) or CV death (P=0.103). Patients with LV apical aneurysm more frequently had baseline sustained VT and SCD-equivalent events; however, Kaplan-Meier analyses indicated no significant differences between groups in incident sustained VT and SCD-equivalent events after enrollment. In multivariable Cox models, age, B-type natriuretic peptide (BNP), and SCD-equivalent events were independently associated with all-cause death; BNP and SCD-equivalent events were independently associated with CV death. CONCLUSIONS: In this cohort, echocardiography-identified LV apical aneurysm was associated with a greater burden of baseline arrhythmic events, but not higher mortality. TTE provides a practical means of identifying this phenotype. BNP and SCD-equivalent events were more closely associated with mortality.
SN - 1347-4820
SN - 1346-9843
ER -