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Multicenter study of the efficacy and safety of disopyramide in obstructive hypertrophic cardiomyopathy

Mark V. Sherrid, MD, FACC^_*,_*, Ivan Barac, MD^_*, William J. McKenna, MD, FACC, Perry M. Elliott, MD, FACC, Shaughan Dickie, DCR, Lidia Chojnowska, MD, PhD, Susan Casey, RN and Barry J. Maron, MD, FACC

^_* St. Luke’s-Roosevelt Hospital Center, Columbia University, College of Physicians and Surgeons, New York, New York
St. George’s Hospital Medical School, London, United Kingdom
National Institute of Cardiology, Warsaw, Poland
Hypertrophic Cardiomyopathy Center, Minneapolis Heart Institute Foundation, Minneapolis, Minnesota.

View larger version (35K): [in a new window]   Figure 1 (Left) Response of peak instantaneous systolic left ventricular outflow tract gradient in patients treated medically with disopyramide (Diso) without the requirement for invasive non-pharmacologic intervention (such as surgical septal myectomy, alcohol septal ablation, or dual-chamber pacing). Depicted are the outflow gradients of 62 patients who had serial echocardiographic assessments with continuous-wave Doppler. (Right) Patients who required invasive intervention because of inadequate relief of heart failure symptoms and persistent outflow gradients. Depicted are the outflow gradients of 33 patients who had serial echocardiographic assessments. All gradient measurements in this group were performed before intervention.

View larger version (30K): [in a new window]   Figure 2 Response of New York Heart Association (NYHA) functional class in patients treated medically with disopyramide (Diso) but without requirement for invasive non-pharmacologic intervention (such as surgical septal myectomy, alcohol septal ablation, or dual-chamber pacing), and in patients with failed maximum medical therapy who ultimately did require such interventions.

View larger version (16K): [in a new window]   Figure 3 Kaplan-Meier survival plot for all-cause cardiac mortality in disopyramide-treated and non-disopyramide-treated patients with obstructive hypertrophic cardiomyopathy.

View larger version (15K): [in a new window]   Figure 4 Kaplan-Meier survival plot for sudden cardiac death in disopyramide-treated and non-disopyramide-treated patients with obstructive hypertrophic cardiomyopathy.