{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T02:59:10Z","timestamp":1790996350728,"version":"4.1.0"},"reference-count":41,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"19","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Apical hypertrophic cardiomyopathy (ApHCM) is a variant of hypertrophic cardiomyopathy, with distinct clinical characteristics and outcomes. We aimed to clarify the natural history of patients with ApHCM and identify the risk of end\u2010stage heart failure incidence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods and Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">\n                      This retrospective study was conducted on patients with hypertrophic cardiomyopathy in China between January 2009 and February 2024. Patients were stratified into ApHCM and non\u2010ApHCM groups. The primary outcome was a composite of major adverse cardiovascular events, including all\u2010cause deaths, heart failure hospitalization, sudden cardiac death, and ventricular tachycardia. The secondary outcome was the incidence of end\u2010stage heart failure, defined as left ventricular ejection fraction &lt;50%. Kaplan\u2010Meier and univariable and multivariable Cox proportional analyses were applied. Adjustment variables were included for important baseline characteristics, comorbidities, and medication use. Of 5653 patients enrolled with hypertrophic cardiomyopathy, 584 (10.3%) had ApHCM and 5069 (89.7%) had non\u2010ApHCM. During the median follow\u2010up period of 4.6\u2009years (1.6\u20138.0\u2009years), major adverse cardiovascular events occurred in 32.2% (n=1808), with a lower incidence in patients with ApHCM than non\u2010ApHCM (20.4% versus 33.3%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Non\u2010ApHCM was an independent predictor of major adverse cardiovascular events (hazard ratio [HR], 1.65 [95% CI, 1.36\u20131.99];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). In the serial cohort, patients with ApHCM exhibited a lower incidence of end\u2010stage heart failure than those with non\u2010ApHCM (12.4% versus 2.7%,\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). Non\u2010ApHCM was associated with a higher risk of end\u2010stage heart failure development (HR, 2.31 [95% CI, 1.28\u20134.15];\n                      <jats:italic>P<\/jats:italic>\n                      &lt;0.001). In subgroup and sensitivity analysis, the results were consistent for our main and secondary outcomes.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">ApHCM is relatively common in hypertrophic cardiomyopathy and shows lower rates of all\u2010cause mortality and heart failure hospitalizations than non\u2010ApHCM.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.124.036663","type":"journal-article","created":{"date-parts":[[2024,9,18]],"date-time":"2024-09-18T05:28:30Z","timestamp":1726637310000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":17,"title":["Clinical Characteristics and Outcomes in Patients With Apical and Nonapical Hypertrophic Cardiomyopathy"],"prefix":"10.1161","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6596-5004","authenticated-orcid":false,"given":"Qin\u2010Fen","family":"Chen","sequence":"first","affiliation":[{"name":"Medical Care Center First Affiliated Hospital of Wenzhou Medical University Wenzhou China"},{"name":"Institute of Aging, Key Laboratory of Alzheimer\u2019s Disease of Zhejiang Province Wenzhou Medical University Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jiahao","family":"Zou","sequence":"additional","affiliation":[{"name":"Medical Care Center First Affiliated Hospital of Wenzhou Medical University Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7638-9217","authenticated-orcid":false,"given":"Christos S.","family":"Katsouras","sequence":"additional","affiliation":[{"name":"Second Department of Cardiology, University Hospital of Ioannina Faculty of Medicine, School of Health Sciences University of Ioannina Ioannina Greece"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shenban","family":"You","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jian","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Cardiology, The Heart Center Zhe Jiang Hospital Hangzhou China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hang\u2010Bin","family":"Ge","sequence":"additional","affiliation":[{"name":"Department of Cardiovascular Medicine, the Heart Center First Affiliated Hospital of Wenzhou Medical University Wenzhou 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