The Natural History of Nonobstructive Hypertrophic Cardiomyopathy
The Natural History of Nonobstructive Hypertrophic Cardiomyopathy
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DOI：
10.1016/j.mayocp.2016.01.002
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发表时间：
2016-03-01
影响因子：
8.9
通讯作者：
Geske, Jeffrey B.
中科院分区：
文献类型：
--
作者：
Hebl, Virginia B.;Miranda, William R.;Geske, Jeffrey B.
目的：描述一个大型非梗阻性肥厚型心肌病（NO-HCM）队列的生存情况，并确定该population.Patients和方法死亡率增加的危险因素：本回顾性观察研究从1975年1月1日至2006年11月30日的马约诊所HCM数据库中确定患者。排除静息或可诱发左心室流出道压差的患者。超声心动图，临床和遗传数据进行了比较亚组之间，生存数据进行了比较与预期的人口rates.Results：共706例NO-HCM患者被确定。在中位随访5年（平均7年）期间，有208例死亡。与年龄和性别匹配的美国白色人群死亡率相比，总生存率与预期无差异（P= 0.77）。死亡的独立预测因素是诊断时的年龄、“烧坏”HCM和短暂性脑缺血发作或卒中史;植入式心律转复除颤器（ICD）的使用与死亡呈负相关。排除ICD患者后，与年龄和性别匹配的个体相比，生存率无差异（P=.39）;年龄、既往短暂性脑缺血发作/卒中和烧坏HCM是死亡的预测因子。结论：在该队列中，NO-HCM患者的生存率与年龄和性别匹配的白色美国人群死亡率相似。尽管ICD的使用与死亡呈负相关，但在排除这些患者后，总生存率没有差异。HCM过度与死亡风险增加独立相关，确定了可能从更积极的治疗中受益的患者子集。(C)2016年马约医学教育和研究基金会
Objective: To describe the survival of a large nonobstructive hypertrophic cardiomyopathy (NO-HCM) cohort and to identify risk factors for increased mortality in this population.Patients and Methods: Patients were identified from the Mayo Clinic HCM database from January 1, 1975, through November 30, 2006, for this retrospective observational study. Patients with resting or provocable left ventricular outflow tract gradients were excluded. Echocardiographic, clinical, and genetic data were compared between subgroups, and survival data were compared with expected population rates.Results: A total of 706 patients with NO-HCM were identified. During median follow-up of 5 years (mean, 7 years), there were 208 deaths. Overall survival was no different than expected compared with age-and sex-matched white US population mortality rates (P=.77). Independent predictors of death were age at diagnosis, "burned out" HCM, and history of transient ischemic attack or stroke; use of an implantable cardioverter defibrillator (ICD) was inversely related to death. After exclusion of patients with an ICD, there was no difference in survival compared with age-and sex-matched individuals (P=.39); age, previous transient ischemic attack/stroke, and burned out HCM were predictors of death.Conclusion: In this cohort, patients with NO-HCM had similar survival rates as age-and sex-matched white US population mortality rates. Although use of an ICD was inversely related to death, no differences in overall survival were seen after those patients were excluded. Burned out HCM was independently associated with an increased risk of death, identifying a subset of patients who may benefit from more aggressive therapies. (C) 2016 Mayo Foundation for Medical Education and Research