Different characteristics of apical aneurysm in hypertrophic cardiomyopathy are related to difference in long-term prognosis

•Overall incidence of AAn in HCM was 9.2%, which was most frequently found in patients with apical and diffuse type of HCM.•Patients with AAn showed a higher risk of MACCEs compared with patients without AAn, especially for CVA.•AAn with thinning and outpouching of the apex or aneurysmal change of the whole apical segment showed the highest risk of MACCEs.