{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,24]],"date-time":"2026-09-24T01:45:41Z","timestamp":1790214341882,"version":"4.1.0"},"reference-count":37,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[2013,7,16]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>We report the predictors of long-term outcomes of symptomatic hypertrophic cardiomyopathy patients undergoing surgical relief of left ventricular outflow tract obstruction.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>\n              We studied 699 consecutive patients who have hypertrophic cardiomyopathy with severe symptomatic left ventricular outflow tract obstruction (47\u00b111 years, 63% male) intractable to maximal medical therapy, who were referred to a tertiary hospital between January 1997 and December 2007 for the surgical relief of left ventricular outflow tract obstruction. We excluded patients &lt;18 years of age, those with an ejection fraction &lt;50%, those with hypertensive heart disease of the elderly, and those with more than mild aortic or mitral stenosis. Clinical, echocardiographic, and Holter data were recorded. A composite end point of death, appropriate internal cardioverter defibrillator discharges, resuscitated from sudden death, documented stroke, and admission for congestive heart failure was recorded. During a mean follow-up of 6.2\u00b13 years, 86 patients (12%) met the composite end point with 30-day, 1-year, and 2-year event rates of 0.7%, 2.8%, and 4.7%, respectively. The hard event rate (death, defibrillator discharge, and resuscitated from sudden death) at 30 days, 1 year, and 2 years was 0%, 1.5%, and 3%, respectively. Stepwise multivariable analysis identified residual postoperative atrial fibrillation (hazard ratio, 2.12; confidence interval, 1.37\u20133.34;\n              <jats:italic>P<\/jats:italic>\n              =0.001) and increasing age (hazard ratio, 1.49; confidence interval, 1.22\u20131.82;\n              <jats:italic>P<\/jats:italic>\n              =0.001) as independent predictors of long-term composite outcomes.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>Symptomatic adult hypertrophic cardiomyopathy patients undergoing surgery for the relief of left ventricular outflow tract obstruction have low event rates during long-term follow-up; worse outcomes are predicted by increasing age and the presence of residual atrial fibrillation during follow-up.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circulationaha.112.000849","type":"journal-article","created":{"date-parts":[[2013,6,15]],"date-time":"2013-06-15T03:27:28Z","timestamp":1371266848000},"page":"209-216","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":193,"title":["Predictors of Long-Term Outcomes in Symptomatic Hypertrophic Obstructive Cardiomyopathy Patients Undergoing Surgical Relief of Left Ventricular Outflow Tract Obstruction"],"prefix":"10.1161","volume":"128","author":[{"given":"Milind Y.","family":"Desai","sequence":"first","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aditya","family":"Bhonsale","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas G.","family":"Smedira","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peyman","family":"Naji","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maran","family":"Thamilarasan","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bruce W.","family":"Lytle","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Harry M.","family":"Lever","sequence":"additional","affiliation":[{"name":"From the Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jama.287.10.1308"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(04)16358-7"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318223e2bd"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa021332"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2005.02.090"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(05)80026-1"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5223(96)70310-0"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1055\/s-2007-1013146"},{"issue":"5","key":"e_1_3_2_10_2","first-page":"V104","article-title":"Results of surgery for hypertrophic obstructive cardiomyopathy.","volume":"76","author":"Williams WG","year":"1987","unstructured":"Williams WG, Wigle ED, Rakowski H, Smallhorn J, LeBlanc J, Trusler GA. 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