JACC:终末期肥厚型心肌病的远期预后研究

2020-06-17 MedSci原创 MedSci原创

晚期的肥厚型心肌病(HCM)是一种较棘手的疾病表现,死亡率和并发症发生率均较高,往往需要接受心脏移植治疗。本研究的目的是用现代管理策略重新评估大规模HCM队列中终末期心力衰竭的临床特征和预后。

晚期的肥厚型心肌病(HCM)是一种较棘手的疾病表现,死亡率和并发症发生率均较高,往往需要接受心脏移植治疗。本研究的目的是用现代管理策略重新评估大规模HCM队列中终末期心力衰竭的临床特征和预后。

本研究纳入分析了2447名HCM患者,其中终末期HCM为118名(平均EF值39 ± 9%,平均年龄48 ± 15岁)。经过平均5.8 ± 4.7年时间的随访,57名患者(48%)通过药物治疗在纽约心功能I/II级中达到临床稳定性。共有61名其他患者(52%)发生难治性心力衰竭,导致纽约心功能等级III/IV(5.2%/年);67%的患者存活,其中31名患者接受了心脏移植。在118例终末期患者中,21例接受了适当的植入式心律转复除颤器(ICD)治疗,终止了潜在的致命性快速心律失常,EF 35%-49%和EF<35%的患者的不良事件发生率无差异(17%vs.19%;p=0.80)。在所有可用的治疗方式下,ES相关死亡率为1.9%/年,10年生存率为85%。

研究结果显示,虽然终末期仍然是HCM的一个重要并发症,但包括ICD和心脏移植在内的现代治疗策略可以明显降低患者死亡率。

原始出处:

Ethan J et al.Outcomes in Patients With Hypertrophic Cardiomyopathy and Left Ventricular Systolic Dysfunction.JACC.2020 June.

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    2020-10-10 hbwxf
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