Surgical myectomy prevents ascending aortic dilation in obstructive hypertrophic cardiomyopathy: A serial cardiac magnetic resonance study

Background The impact of septal myectomy on the progression of ascending aortic (AAo) dilation in patients with obstructive hypertrophic cardiomyopathy (HOCM) remains uncertain. This study aimed to investigate the relationship between septal myectomy and AAo dilation in HOCM patients. Methods A total of 69 patients with HOCM were enrolled. All the participants underwent sequential cardiac magnetic resonance scans at a mean interval of 5.13 ± 2.04 years, with each scan being more than 3 years apart. Results At baseline, 17 patients with HOCM (25%) exhibited AAo dilation (Indexed AAo dimension> 19 mm/m²). Age (OR 1.10, 95%CI: 1.01-1.019, P = 0.026) and female (OR 4.80, 95%CI: 1.05-21.93, P = 0.043) were identified as independent risk factors for AAo dilation. In patients who underwent myectomy, the AAo dimension at follow-up was similar to that at baseline (32.47 ± 4.70mm vs. 32.81 ± 5.06mm, P=0.197). Furthermore, the rate of AAo dilation was lowere in patients with myectomy compared to those without myectomy (-0.06 ± 0.38mm/year vs. 0.18 ± 0.43mm/year, P=0.016). Additionally, moderate or severe mitral regurgitation was significantly associated with AAo dilation rate (B=0.273, P=0.032). Conclusions These findings suggest that surgical myectomy may help prevent AAo dilation in patients with HOCM.