Clinical course of hypertrophic cardiomyopathy with survival to advanced age
Clinical course of hypertrophic cardiomyopathy with survival to advanced age
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DOI：
10.1016/s0735-1097(03)00855-6
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发表时间：
2003-09-03
影响因子：
24
通讯作者：
Aeppli, DM
中科院分区：
文献类型：
--
作者：
Maron, BJ;Casey, SA;Aeppli, DM
结论本研究旨在阐明和解决老年肥厚型心肌病（HCM）患者的临床概况。背景HCM的不良后果，如猝死和失能症状已被强调的青年和中年。方法HCM的长期结果进行了评估，在一个社区为基础的队列不受三级中心，转诊偏倚。结果312例患者，73例（23%）达到正常预期寿命（75岁;范围至96岁）; 44例（14%）大于或等于80岁。大多数大于或等于75岁的患者（47; 64%）没有或只有轻微的限制性症状，几乎一生都没有HCM相关的临床后果; 26例患者（36%）出现严重的进行性症状。在老年HCM患者中，诊断和症状发作分别延迟至74 +/- 8岁和70 +/- 11岁。对于确诊时年龄大于或等于50岁的患者，5年、10年和15年的生存概率分别为85 +/-3%、74 +/-4%和57 +/-6%，与匹配的一般人群无显著差异（p = 0.20）。大于或等于75岁的患者主要是女性，并且壁厚较薄，基底流出道梗阻大于或等于30 mm Hg的频率更高（与大于或等于30 mm Hg的患者相比，
OBJECTIVES This study was designed to clarify and resolve the clinical profile of older patients with hypertrophic cardiomyopathy (HCM).BACKGROUND Adverse consequences of HCM such as sudden death and incapacitating symptoms have been emphasized for the young and middle-aged.METHODS Long-term outcome of HCM was assessed in a community-based cohort not subject to tertiary center, referral bias.RESULTS Of 312 patients, 73 (23%) achieved normal fife expectancy ( 75 years; range to 96); 44 (14%) were greater than or equal to80 years old. Most patients greater than or equal to75 years (47; 64%) experienced no or only mild,limiting symptoms and lived virtually their entire lives with few HCM-related clinical consequences; 26 patients (36%) experienced severe progressive symptoms. In elderly patients with HCM, diagnosis and symptom onset were considerably delayed to 74 +/- 8 and 70 +/- 11 years, respectively. For patients greater than or equal to50 years at diagnosis, the probability of survival for 5, 10, and 15 years was 85 +/- 3%, 74 +/- 4%, and 57 +/- 6%, respectively, and did not significantly differ from a matched general population (p = 0.20). Patients greater than or equal to75 years were predominantly women, and had less marked wall thickness and more frequently showed basal outflow obstruction greater than or equal to30 mm Hg (compared with those