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(Circulation. 1995;92:785-789.)
© 1995 American Heart Association, Inc.
Articles |
Prevalence of Hypertrophic Cardiomyopathy in a General Population of Young Adults
Echocardiographic Analysis of 4111 Subjects in the CARDIA Study
From the Cardiovascular Research Division, Minneapolis Heart Institute Foundation; Divisions of Cardiology and Epidemiology, University of California, Irvine Medical Center, Orange; Division of General and Preventive Medicine, University of Minnesota School of Medicine, Minneapolis; Division of Pediatric Cardiology, Northwestern University Medical School, Chicago, Ill; and Division of Epidemiology and Clinical Applications, NHLBI, NIH, Bethesda, Md.
Correspondence to Dr Barry J. Maron, Cardiovascular Research Division, Minneapolis Heart Institute Foundation, 920 E 28th St, Ste 40, Minneapolis, MN 55407.
Background Hypertrophic cardiomyopathy (HCM) is a genetically transmitted disease and an important cause of morbidity and sudden cardiac death in young people, including competitive athletes. At present, however, few data exist to estimate the prevalence of this disease in large populations.
Methods and Results As part of the Coronary Artery Risk
Development in (Young) Adults (CARDIA) Study, an epidemiological study
of coronary risk factors, 4111 men and women 23 to 35 years of
age selected from the general population of four urban centers had
technically satisfactory echocardiographic studies
during 1987 through 1988. Probable or definite
echocardiographic evidence of HCM was present in 7
subjects (0.17%) on the basis of identification of a hypertrophied,
nondilated left ventricle and maximal wall thickness 
15 mm that were
not associated with systemic hypertension. Prevalence in men and women
was 0.26:0.09%; in blacks and whites, 0.24:0.10%.
Ventricular septal thickness was 15 to 21 mm (mean, 17 mm)
in the 7 subjects. Only 1 of the 7 subjects had ever experienced
important cardiac symptoms attributable to HCM, had previously been
suspected of having cardiovascular disease, or had
obstruction to left ventricular outflow; 4 other subjects
had relatively mild systolic anterior motion of the mitral valve that
was insufficient to produce dynamic basal outflow obstruction. ECGs
were abnormal in 5 of the 7 subjects. Five other study subjects had
left ventricular wall thicknesses of 15 to 21 mm that were
a consequence of systemic hypertension.
Conclusions HCM was present in about 2 of 1000 young adults. These unique population-based data will aid in assessments of the impact of HCM-related mortality and morbidity in the general population and the practicality of screening large populations for HCM, including those comprising competitive athletes.
Key Words: cardiomyopathy • echocardiography • hypertrophy
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Writing Committee Members, B. J. Maron, W. J. McKenna, G. K. Danielson, L. J. Kappenberger, H. J. Kuhn, C. E. Seidman, P. M. Shah, W. H. Spencer III, P. Spirito, et al. American College of Cardiology/European Society of Cardiology Clinical Expert Consensus Document on Hypertrophic Cardiomyopathy: A report of the American College of Cardiology Foundation Task Force on Clinical Expert Consensus Documents and the European Society of Cardiology Committee for Practice Guidelines Eur. Heart J., November 1, 2003; 24(21): 1965 - 1991. [Full Text] [PDF]
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M. Alders, R. Jongbloed, W. Deelen, A. van den Wijngaard, P. Doevendans, F. Ten Cate, V. Regitz-Zagrosek, H.-P. Vosberg, I. van Langen, A. Wilde, et al. The 2373insG mutation in the MYBPC3 gene is a founder mutation, which accounts for nearly one-fourth of the HCM cases in the Netherlands Eur. Heart J., October 2, 2003; 24(20): 1848 - 1853. [Abstract] [Full Text] [PDF]
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J. P. Schmitt, C. Semsarian, M. Arad, J. Gannon, F. Ahmad, C. Duffy, R. T. Lee, C. E. Seidman, and J.G. Seidman Consequences of Pressure Overload on Sarcomere Protein Mutation-Induced Hypertrophic Cardiomyopathy Circulation, September 2, 2003; 108(9): 1133 - 1138. [Abstract] [Full Text] [PDF]
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 M. Garcia-Castro, J. R. Reguero, A. Batalla, B. Diaz-Molina, P. Gonzalez, V. Alvarez, A. Cortina, G. I. Cubero, and E. Coto Hypertrophic Cardiomyopathy: Low Frequency of Mutations in the {beta}-Myosin Heavy Chain (MYH7) and Cardiac Troponin T (TNNT2) Genes among Spanish Patients Clin. Chem., August 1, 2003; 49(8): 1279 - 1285. [Abstract] [Full Text] [PDF]
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S. L. Van Driest, E. G. Ellsworth, S. R. Ommen, A. J. Tajik, B. J. Gersh, and M. J. Ackerman Prevalence and Spectrum of Thin Filament Mutations in an Outpatient Referral Population With Hypertrophic Cardiomyopathy * Note Added in Proof Circulation, July 29, 2003; 108(4): 445 - 451. [Abstract] [Full Text] [PDF]
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 E. G. Nabel Cardiovascular Disease N. Engl. J. Med., July 3, 2003; 349(1): 60 - 72. [Full Text] [PDF]
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C. G. Nebigil, F. Jaffre, N. Messaddeq, P. Hickel, L. Monassier, J.-M. Launay, and L. Maroteaux Overexpression of the Serotonin 5-HT2B Receptor in Heart Leads to Abnormal Mitochondrial Function and Cardiac Hypertrophy Circulation, July 1, 2003; 107(25): 3223 - 3229. [Abstract] [Full Text] [PDF]
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J. G. Crilley, E. A. Boehm, E. Blair, B. Rajagopalan, A. M. Blamire, P. Styles, W. J. McKenna, I. Ostman-Smith, K. Clarke, and H. Watkins Hypertrophic cardiomyopathy due to sarcomeric gene mutations is characterized by impaired energy metabolism irrespective of the degree of hypertrophy J. Am. Coll. Cardiol., May 21, 2003; 41(10): 1776 - 1782. [Abstract] [Full Text] [PDF]
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P. Richard, P. Charron, L. Carrier, C. Ledeuil, T. Cheav, C. Pichereau, A. Benaiche, R. Isnard, O. Dubourg, M. Burban, et al. Hypertrophic Cardiomyopathy: Distribution of Disease Genes, Spectrum of Mutations, and Implications for a Molecular Diagnosis Strategy Circulation, May 6, 2003; 107(17): 2227 - 2232. [Abstract] [Full Text] [PDF]
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D. J. Lips, L. J. deWindt, D. J.W. van Kraaij, and P. A. Doevendans Molecular determinants of myocardial hypertrophy and failure: alternative pathways for beneficial and maladaptive hypertrophy Eur. Heart J., May 2, 2003; 24(10): 883 - 896. [Abstract] [Full Text] [PDF]
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J Mogensen, A Bahl, T Kubo, N Elanko, R Taylor, and W J McKenna Comparison of fluorescent SSCP and denaturing HPLC analysis with direct sequencing for mutation screening in hypertrophic cardiomyopathy J. Med. Genet., May 1, 2003; 40(5): e59 - 59. [Full Text] [PDF]
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A. J. Marian On predictors of sudden cardiac death in hypertrophic cardiomyopathy J. Am. Coll. Cardiol., March 19, 2003; 41(6): 994 - 996. [Full Text] [PDF]
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J. Mogensen, A. Bahl, and W. J McKenna Hypertrophic cardiomyopathy--the clinical challenge of managing a hereditary heart condition Eur. Heart J., March 2, 2003; 24(6): 496 - 498. [Full Text] [PDF]
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