Sayed Ahmed, Maron Barry J, Rowin Ethan J, Maron Martin S
Faculty of Medicine, Ain Shams University Cairo Egypt.
Houston Methodist DeBakey Heart & Vascular Center Houston TX USA.
J Am Heart Assoc. 2025 Apr;14(7):e037047. doi: 10.1161/JAHA.124.037047. Epub 2025 Mar 25.
Dedicated hypertrophic cardiomyopathy (HCM) center cohorts have reported reductions in HCM-related deaths, likely due to the introduction of contemporary treatments. Similar declining HCM mortality rates are reported in the general US population over 2 decades (1999-2019), but the impact of the COVID-19 pandemic on HCM has not been assessed.
Age-adjusted mortality rates based on death certificates from 1999 to 2022 were extracted from the Centers for Disease Control and Prevention Wide-Ranging Online Data for Epidemiological Research. HCM-related mortality trends were compared with non-HCM cardiovascular deaths and all-cause deaths. Excess HCM-related deaths were estimated during the 2020 to 2022 COVID-19 pandemic. From 1999 to 2019, HCM-related age-adjusted mortality rates declined progressively, reaching a cumulative 53% (95% CI, 50%-56%) reduction in 2019, exceeding declines in non-HCM cardiovascular disease (25%) and all-cause deaths (18%). Declines were evident among all age groups but were most substantial among patients aged 15 to 24 years (62%; 95% CI, 47%-73%) and 25 to 44 years (62% [95% CI, 56%-68%]) but less so in patients aged ≥65 years. During the COVID-19 pandemic, HCM-related deaths by 31% (95% CI, 23%-40%), exceeding increases in non-HCM cardiovascular and all-cause deaths. During the pandemic, 5462 HCM-related deaths were observed compared with 4770 expected deaths on the basis of the preceding period, resulting in a 692 estimated excess HCM-related deaths (95% CI, 554-830).
Based on an analysis of death certificates, the marked decline in HCM-related deaths of >50% achieved in the US general population during the 2 decades from 1999 to 2019 was substantially reversed (by 29%) during the subsequent 3-year COVID-19 pandemic.
专门的肥厚型心肌病（HCM）中心队列报告称，HCM相关死亡人数有所减少，这可能归因于当代治疗方法的引入。在美国普通人群中，过去20年（1999 - 2019年）也有类似的HCM死亡率下降情况，但新冠疫情对HCM的影响尚未得到评估。
从疾病控制与预防中心的广泛在线流行病学研究数据中提取了1999年至2022年基于死亡证明的年龄调整死亡率。将HCM相关的死亡率趋势与非HCM心血管疾病死亡和全因死亡进行比较。估计了2020年至2022年新冠疫情期间HCM相关的超额死亡人数。从1999年到2019年，HCM相关的年龄调整死亡率逐渐下降，到2019年累计下降了53%（95%CI，50% - 56%），超过了非HCM心血管疾病（25%）和全因死亡（18%）的下降幅度。各年龄组均有明显下降，但在15至24岁患者中下降最为显著（62%；95%CI，47% - 73%）和25至44岁患者中（62%[95%CI，56% - 68%]），而在≥65岁患者中下降幅度较小。在新冠疫情期间，HCM相关死亡人数增加了31%（95%CI，23% - 40%），超过了非HCM心血管疾病和全因死亡人数的增加幅度。在疫情期间，观察到5462例HCM相关死亡，而根据前期情况预计为4770例死亡，导致估计有692例HCM相关超额死亡（95%CI，554 - 830）。
基于对死亡证明的分析，在1999年至2019年的2十年间，美国普通人群中HCM相关死亡人数显著下降超过50%，但在随后的3年新冠疫情期间，这一趋势大幅逆转（逆转了29%）。
