Construction and verification of a diagnostic nomogram for heart failure in hypertrophic cardiomyopathy based on conventional clinical indicators: a case-control study

Heart failure (HF) manifests variably in patients with hypertrophic cardiomyopathy (HCM). This study developed and validated a diagnostic nomogram that uses routine clinical indicators to identify HF in individuals with HCM. Independent diagnostic indicators of HF in patients with HCM included B-type natriuretic peptide (BNP) (OR = 1.003, P < 0.001), diuretics (OR = 3.69, P = 0.014), and myocardial ischemia (OR = 4.99, P = 0.002). The diagnostic model demonstrated robust performance in both the training set and the validation set, yielding AUCs of 0.917 (95% CI: 0.879-0.955) and 0.929 (95% CI: 0.873-0.984), respectively. At an optimal threshold of 0.157, the training set exhibited sensitivity and specificity of 89.1% and 79.9%, respectively, while the validation set showed sensitivity and specificity of 90.9% and 82.9%, respectively. The calibration curve indicated a good fit, and DCA revealed that the model provided a net clinical benefit. In this study, the developed nomogram model accurately identifies HF in patients with HCM, aiding in diagnostic stratification and personalized management.Clinical Trial Registration This study was registered retrospectively at the Chinese Clinical Trial Registry ( http://www.chictr.org.cn/ ), registration number ChiCTR2500106648 (Registration Date: 2025-07-28).