{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:40:27Z","timestamp":1760060427708,"version":"build-2065373602"},"reference-count":30,"publisher":"MDPI AG","issue":"9","license":[{"start":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T00:00:00Z","timestamp":1755820800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCDD"],"abstract":"<jats:p>Background: A modified Morrow septal myectomy (MMSM) is one of the main treatment methods for obstructive hypertrophic cardiomyopathy (OHCM). Our aim was to study the impact of MMSM on the risk of AF and stroke in OHCM patients. Methods and Results: From 1 January 2014 to 31 December 2020, 6426 patients with obstructive HCM (OHCM) were selected from the Beijing Municipal Health Commission Information Center (BMHCIC) datasets (mean age: 54.3 years; 43.8% female). After propensity score matching, 3780 patients were selected, including 1890 who received MMSM (Group 1) and 1890 who did not receive any surgery (Group 2). During a median of 0.8 (interquartile range [IQR]: 0.1, 2.7) years of follow-up after discharge from the hospital, stroke risk was lower in Group 1 compared to Group 2 (aHR: 0.4, 95%CI: 0.2\u20130.6, p &lt; 0.001), and the results were further confirmed by Kaplan\u2013Meier analyses (p &lt; 0.001). There was no statistically significant difference in the risk of AF (aHR: 1.0, 95%CI: 0.7\u20131.5, p = 0.991). The risk of AF decreased in the first 6 years since receiving MMSM and then sharply increased beyond 6 years after MMSM according to Kaplan\u2013Meier analyses. Conclusions: MMSM is associated with a decreased risk of stroke in OHCM patients. The risk of AF decreased in the first 6 years since receiving MMSM and then sharply increased beyond 6 years after MMSM.<\/jats:p>","DOI":"10.3390\/jcdd12090321","type":"journal-article","created":{"date-parts":[[2025,8,22]],"date-time":"2025-08-22T11:50:31Z","timestamp":1755863431000},"page":"321","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Risk of Atrial Fibrillation and Stroke in Patients with Hypertrophic Obstructive Cardiomyopathy Treated by Modified Morrow Septal Myectomy: Reports of a Propensity Score Matching Cohort"],"prefix":"10.3390","volume":"12","author":[{"given":"Yi-Xi","family":"Zou","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Xi-Lin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jian-Peng","family":"Zheng","sequence":"additional","affiliation":[{"name":"Beijing Municipal Health Commission Information Center, Beijing 100054, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Feng","family":"Lu","sequence":"additional","affiliation":[{"name":"Beijing Municipal Health Commission Information Center, Beijing 100054, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-1626","authenticated-orcid":false,"given":"Gregory Y. H.","family":"Lip","sequence":"additional","affiliation":[{"name":"Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores Universtiy and Liverpool Heart & Chest Hospital, Liverpool L69 3BX, UK"},{"name":"Department of Clinical Medicine, Aalborg University, 7K 9220 Aalborg, Denmark"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ying","family":"Bai","sequence":"additional","affiliation":[{"name":"Cardiovascular Center, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yu-Feng","family":"Sun","sequence":"additional","affiliation":[{"name":"Clinical Medical Laboratory, Beijing Tongren Hospital, Capital Medical University, Beijing 100176, China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Wei-Hua","family":"Guo","sequence":"additional","affiliation":[{"name":"Dongzhimen Hospital, Beijing University of Chinese Medicine, Beijing 101121, China"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,22]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1016\/j.jacc.2021.12.002","article-title":"Diagnosis and Evaluation of Hypertrophic Cardiomyopathy: JACC State-of-the-Art Review","volume":"79","author":"Maron","year":"2022","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_2","first-page":"2849","article-title":"The 2014 ESC Guidelines on the Diagnosis and Management of Hypertrophic Cardiomyopathy have been published","volume":"35","author":"Nicholls","year":"2014","journal-title":"Eur. Heart J."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"102503","DOI":"10.1016\/j.jchf.2025.03.044","article-title":"Hypertrophic Cardiomyopathy with Midventricular Obstruction Is Not Nonobstructive Hypertrophic Cardiomyopathy","volume":"13","author":"Seggewiss","year":"2025","journal-title":"JACC Heart Fail."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"165","DOI":"10.1007\/s11886-021-01600-5","article-title":"Septal Ablation Versus Surgical Myomectomy for Hypertrophic Obstructive Cardiomyopathy","volume":"23","author":"Pelliccia","year":"2021","journal-title":"Curr. Cardiol. Rep."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"539","DOI":"10.1016\/j.atssr.2024.10.007","article-title":"Septal Myectomy for Isolated Midventricular Obstruction After Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy","volume":"3","author":"Karadzha","year":"2025","journal-title":"Ann. Thorac. Surg. Short Rep."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1186\/s43044-025-00652-0","article-title":"Cardiac myosin inhibitors: Efficacy, safety and future directions of aficamten in hypertrophic obstructive cardiomyopathy","volume":"77","author":"Ogieuhi","year":"2025","journal-title":"Egypt. Heart J."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"759","DOI":"10.1016\/S0140-6736(20)31792-X","article-title":"Mavacamten for treatment of symptomatic obstructive hypertrophic cardiomyopathy (EXPLORER-HCM): A randomised, double-blind, placebo-controlled, phase 3 trial","volume":"396","author":"Olivotto","year":"2020","journal-title":"Lancet"},{"key":"ref_8","first-page":"800","article-title":"The Revolution of Cardiac Myosin Inhibitors in Patients with Hypertrophic Cardiomyopathy","volume":"40","author":"Haraf","year":"2024","journal-title":"Can. J. Cardiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"e012545","DOI":"10.1161\/CIRCHEARTFAILURE.124.012545","article-title":"Stop Dreaming: Mavacamten REMS Data Are Here","volume":"18","author":"Masri","year":"2025","journal-title":"Circ. Heart Fail."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"575","DOI":"10.1016\/j.jacc.2023.05.052","article-title":"First-in-Human Transapical Beating-Heart Septal Myectomy in Patients With Hypertrophic Obstructive Cardiomyopathy","volume":"82","author":"Fang","year":"2023","journal-title":"J. Am. Coll. Cardiol."},{"key":"ref_11","first-page":"132","article-title":"Surgical septal myectomy for hypertrophic cardiomyopathy in Greece: A single-center initial experience","volume":"55","author":"Efthimiadis","year":"2014","journal-title":"Hell. J. Cardiol."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"e9371","DOI":"10.1097\/MD.0000000000009371","article-title":"Comparison of surgical results in patients with hypertrophic obstructive cardiomyopathy after classic or modified morrow septal myectomy","volume":"96","author":"Lai","year":"2017","journal-title":"Medicine"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"344","DOI":"10.1055\/s-2004-830323","article-title":"Extended myectomy for hypertrophic obstructive cardiomyopathy after failure or contraindication of septal ablation or with combined surgical procedures","volume":"52","author":"Schmitto","year":"2004","journal-title":"Thorac. Cardiovasc. Surg."},{"key":"ref_14","doi-asserted-by":"crossref","unstructured":"Pronovost, H., Kassamali, A.A., Ehmsen, J., Rivers, B., Gasperetti, A., Wu, K.C., Rowin, E., Madrazo, J.A., and Carrick, R.T. (2025). External validation of atrial fibrillation risk prediction tools in a racially diverse cohort of patients with hypertrophic cardiomyopathy. Heart Rhythm.","DOI":"10.1016\/j.hrthm.2025.05.046"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1556","DOI":"10.4022\/jafib.1556","article-title":"Atrial Fibrillation in Hypertrophic Cardiomyopathy: Diagnosis and Considerations for Management","volume":"10","author":"Patten","year":"2018","journal-title":"J. Atr. Fibrillation"},{"key":"ref_16","doi-asserted-by":"crossref","unstructured":"Tian, H., Cui, J., Yang, C., Hu, F., Yuan, J., Liu, S., Yang, W., Jiang, X., and Qiao, S. (2018). Left ventricular remodeling in hypertrophic cardiomyopathy patients with atrial fibrillation. BMC Cardiovasc. Disord., 18.","DOI":"10.1186\/s12872-018-0945-7"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"41","DOI":"10.1016\/j.ijcard.2023.05.043","article-title":"Stroke in hypertrophic cardiomyopathy. Never mind the rhythm","volume":"385","author":"Pieroni","year":"2023","journal-title":"Int. J. Cardiol."},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Bai, Y., Zheng, J.-P., Lu, F., Zhang, X.-L., Sun, C.-P., Guo, W.-H., Zou, Y.-X., Lip, G.Y.H., and Shi, X.-B. (2022). Prevalence, incidence and mortality of hypertrophic cardiomyopathy based on a population cohort of 21.9 million in China. Sci. Rep., 12.","DOI":"10.1038\/s41598-022-20042-9"},{"key":"ref_19","first-page":"835","article-title":"The design and implementation of the tenth revision of the international classification of disease clinical modification of beijing","volume":"27","author":"Huang","year":"2011","journal-title":"Chin. J. Hosp. Adm."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"2517","DOI":"10.1161\/hc4601.097997","article-title":"Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy","volume":"104","author":"Olivotto","year":"2001","journal-title":"Circulation"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"1918","DOI":"10.1016\/j.athoracsur.2021.08.081","article-title":"Patient-Reported Atrial Fibrillation After Septal Myectomy for Hypertrophic Cardiomyopathy","volume":"113","author":"Sun","year":"2022","journal-title":"Ann. Thorac. Surg."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"24219","DOI":"10.18632\/aging.104133","article-title":"Stroke risk in hypertrophic cardiomyopathy patients with atrial fibrillation: A nationwide database study","volume":"12","author":"Hsu","year":"2020","journal-title":"Aging"},{"key":"ref_23","first-page":"465","article-title":"Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: Systematic review","volume":"100","author":"Guttmann","year":"2014","journal-title":"Heart Br. Card. Soc."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1093\/ejcts\/ezs332","article-title":"A retrospective clinical study of transaortic extended septal myectomy for obstructive hypertrophic cardiomyopathy in China","volume":"43","author":"Wang","year":"2013","journal-title":"Eur. J. Cardio-Thorac. Surg."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"1925","DOI":"10.1016\/j.athoracsur.2021.09.075","article-title":"Atrial Fibrillation in Obstructive Hypertrophic Cardiomyopathy: Seek, Find, and Treat","volume":"113","author":"Gerdisch","year":"2022","journal-title":"Ann. Thorac. Surg."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"1781","DOI":"10.1161\/01.CIR.90.4.1781","article-title":"Hypertrophic obstructive cardiomyopathy. Initial results and long-term follow-up after Morrow septal myectomy","volume":"90","author":"Suttorp","year":"1994","journal-title":"Circulation"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"673","DOI":"10.1253\/jcj.61.673","article-title":"Incidence of ischemic strokes in hypertrophic cardiomyopathy is markedly increased if complicated by atrial fibrillation","volume":"61","author":"Higashikawa","year":"1997","journal-title":"Jpn. Circ. J."},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"936","DOI":"10.1161\/STROKEAHA.115.012130","article-title":"Stroke and Embolic Events in Hypertrophic Cardiomyopathy: Risk Stratification in Patients Without Atrial Fibrillation","volume":"47","author":"Haruki","year":"2016","journal-title":"Stroke"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"70","DOI":"10.1016\/j.ijcard.2023.04.008","article-title":"Incidence of stroke in patients with hypertrophic cardiomyopathy in stable sinus rhythm during long-term monitoring","volume":"381","author":"Fumagalli","year":"2023","journal-title":"Int. J. Cardiol."},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"939","DOI":"10.1007\/s11883-022-01067-x","article-title":"A Contemporary Review of Epidemiology, Risk Factors, Etiology, and Outcomes of Premature Stroke","volume":"24","author":"Potter","year":"2022","journal-title":"Curr. Atheroscler. Rep."}],"container-title":["Journal of Cardiovascular Development and Disease"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2308-3425\/12\/9\/321\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T18:33:32Z","timestamp":1760034812000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2308-3425\/12\/9\/321"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8,22]]},"references-count":30,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2025,9]]}},"alternative-id":["jcdd12090321"],"URL":"https:\/\/doi.org\/10.3390\/jcdd12090321","relation":{},"ISSN":["2308-3425"],"issn-type":[{"type":"electronic","value":"2308-3425"}],"subject":[],"published":{"date-parts":[[2025,8,22]]}}}