Comparative characteristics of pregnancy course in women with hypertrophic cardiomyopathy: data from the perinatal center registry of the Almazov National Medical Research Centre

Objective . To compare clinical and anamnestic data and echocardiographic parameters in patients with obstructive and non-obstructive forms of hypertrophic cardiomyopathy (HCM) examined at a specialized centre for pregnancy and cardiac disease. Design and methods . A retrospective analysis of 100 pregnancy cases in patients with HCM (mean age 29,8 ± 6,0 years) from 2011 to 2025 was conducted. Patients were divided into groups based on left ventricular outflow tract (LVOT) obstruction and prior pregnancy history. Clinical and echocardiographic parameters, along with the frequency of pregnancy complications, were assessed. Statistical analysis was performed using the R programming language (Student’s t-test, Mann–Whitney U test, χ², linear regression). Results . The clinical manifestations of the disease did not differ between the forms of HCM. An increase in left atrial diameter was observed in the third trimester compared to the second trimester, along with a trend toward a reduction in the peak LVOT obstruction gradient by the third trimester. Analysis of life-threatening arrhythmias (ventricular tachycardia) showed no significant differences between patients with different HCM forms. A higher frequency of ventricular arrhythmias was noted in patients with non-obstructive HCM during the first trimester. Conclusions . Pregnancy in patients with HCM is associated with an increased incidence of ventricular arrhythmias and a higher estimated risk of sudden cardiac death (SCD) according to the European Society of Cardiology ESC HCM Risk-SCD risk score. The analysis revealed no significant differences in pregnancy course between patients with obstructive and non-obstructive forms of HCM.