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JAHA：非梗阻性、不稳定性和梗阻性肥厚性心肌病患者的临床结局分析！

2018-02-26 xing.T MedSci原创

非梗阻性不稳定性梗阻性HCM临床结局
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由此可见，非梗阻性HCM患者常伴有显著的并发症，包括比其他HCM患者有更高的心律失常风险。不稳定型HCM患者具有相对良性的临床病程。该研究的数据显示需要对非梗阻性HCM患者进行详细的心脏性猝死危险分层。

肥厚型心肌病（HCM）是一种常见的遗传性心脏病，具有不同程度的左心室流出道梗阻。近日，心血管疾病领域权威杂志JAHA上发表了一篇研究文章。在一个大型队列中，研究人员比较3个不同血流动力学组的临床结局。

研究人员前瞻性地招募了2005年1月至2015年6月期间符合HCM诊断标准的患者，采用超声心动图测定了包含静息和激发后的左心室流出道压力峰值在内的详细表型特征。主要结果是一个复合心血管终点，包括新发房颤、新发持续性室性心动过速和室颤、新发的或恶化的心力衰竭以及死亡。

平均随访时间为3.4±2.8年，在705例HCM患者（平均年龄为52±15岁，62%为男性），230例阻塞性HCM患者年龄较大，有较大的体重指数和纽约心功能分级。214例非梗阻性HCM患者更可能伴有持续性室性心动过速、心室颤动和心脏复律除颤器植入术病史。随访期间，121名患者发生了复合心血管终点。阻塞性HCM患者中房颤最为常见。非梗阻性HCM患者伴有更频繁的持续性室速/室颤事件。在多变量分析中，阻塞性（风险比为2.80；95%可信区间为1.64-4.80）和非梗阻性（风险比为1.94；95%可信区间为1.09-3.45）HCM患者比不稳定HCM患者发生不良事件的可能性更大。

由此可见，非梗阻性HCM患者常伴有显著的并发症，包括比其他HCM患者有更高的心律失常风险。不稳定型HCM患者具有相对良性的临床病程。该研究的数据显示需要对非梗阻性HCM患者进行详细的心脏性猝死危险分层。

原始出处：

Dai‐Yin Lu,et al. Clinical Outcomes in Patients With Nonobstructive, Labile, and Obstructive Hypertrophic Cardiomyopathy.JAHA.2018. https://doi.org/10.1161/JAHA.117.006657

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    2018-12-28 mei531

    #临床结局#

    0

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    2018-06-06 mgqwxj

    #非梗阻性#

    0

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    2018-11-16 jiangfeng5067

    #稳定性#

    0

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    2018-02-28 13718711b3m

    学习了.获益匪浅.感谢分享

    0

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    2018-02-28 zhaohui6731

    #AHA#

    0

  6. [GetPortalCommentsPageByObjectIdResponse(id=1843148, encodeId=11131843148d5, content=<a href='/topic/show?id=3d052296e4e' target=_blank style='color:#2F92EE;'>#临床结局#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=24, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=22967, encryptionId=3d052296e4e, topicName=临床结局)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7fbd46, createdName=mei531, createdTime=Fri Dec 28 19:11:00 CST 2018, time=2018-12-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1819442, encodeId=54fd181944262, content=<a href='/topic/show?id=ecb69948913' target=_blank style='color:#2F92EE;'>#非梗阻性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=47, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=99489, encryptionId=ecb69948913, topicName=非梗阻性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=669d219, createdName=mgqwxj, createdTime=Wed Jun 06 06:11:00 CST 2018, time=2018-06-06, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1900473, encodeId=1d6619004e393, content=<a href='/topic/show?id=0983e529745' target=_blank style='color:#2F92EE;'>#稳定性#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=30, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=75297, encryptionId=0983e529745, topicName=稳定性)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=e0a1165, createdName=jiangfeng5067, createdTime=Fri Nov 16 19:11:00 CST 2018, time=2018-11-16, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=291629, encodeId=00932916297d, content=学习了.获益匪浅.感谢分享, beContent=null, objectType=article, channel=null, level=null, likeNumber=51, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=https://cdnapi.center.medsci.cn/medsci/head/2018/02/27/c53a212859edcad4f60a54feffff50bb.jpg, createdBy=67cf1525321, createdName=13718711b3m, createdTime=Wed Feb 28 07:53:54 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1267736, encodeId=6eb0126e73686, content=<a href='/topic/show?id=922f21183d' target=_blank style='color:#2F92EE;'>#AHA#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=33, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2118, encryptionId=922f21183d, topicName=AHA)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=bf3d82, createdName=zhaohui6731, createdTime=Wed Feb 28 01:11:00 CST 2018, time=2018-02-28, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1622311, encodeId=4481162231195, content=<a href='/topic/show?id=b9578094833' target=_blank style='color:#2F92EE;'>#肌病#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=0, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=80948, encryptionId=b9578094833, topicName=肌病)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=395f25, createdName=爆笑小医, createdTime=Wed Feb 28 01:11:00 CST 2018, time=2018-02-28, status=1, ipAttribution=)]
    2018-02-28 爆笑小医

    #肌病#

    0