Clinical characteristics, treatment; and outcome of tachycardia induced cardiomyopathy
Clinical characteristics, treatment; and outcome of tachycardia induced cardiomyopathy
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DOI：
10.1536/ihj.49.39
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发表时间：
2008-01-01
影响因子：
1.5
通讯作者：
Aizawa, Yoshifusa
中科院分区：
文献类型：
--
作者：
Watanabe, Hiroshi;Okamura, Kazuki;Aizawa, Yoshifusa
心动过速性心肌病的特征是心室收缩功能障碍和充血性心力衰竭，由持续或高频率的心动过速引起，心率不受控制。虽然这种疾病是可逆的，而且通常被认为是良性的，但很少有研究调查这种疾病的后果。对12例连续发生的心动过速性心肌病患者（9例男性，年龄51.9±17.6岁）的临床特征、治疗方法和远期预后进行了研究。发生心动过速至发生充血性心力衰竭的平均时间为26.0±34.3天。入院时平均心率为156.3±28.7次/分。所有患者均有严重心力衰竭，NYHA功能等级为2.3 +/- 0.5，左心室射血分数为0.32 +/- 0.10，脑利钠肽水平为505.7 +/- 449.1 pg/mL。在所有患者中，心功能障碍在53.5±61.3天后恢复。在53 +/- 24个月的随访中，2例患者心衰复发并无控制的心动过速，1例患者猝死。在心动过速性心肌病中，心功能障碍恢复后可出现复发性心衰伴不可控的心动过速和猝死。心衰和/或危及生命的心律失常的底物可能持续存在，需要仔细的长期随访。
Tachycardia-induced cardiomyopathy is characterized by ventricular systolic dysfunction and congestive heart failure resulting from persistent or highly frequent tachyarrhythmias with uncontrolled heart rate. While reversible and often considered benign, few studies have examined the outcome of the disorder.The clinical characteristics, treatment, and long-term outcomes of 12 consecutive patients with tachycardia-induced cardiomyopathy (9 men, age, 51.9 +/- 17.6 years) were studied. The mean period between the occurrence of tachyarrbythmias and the development of congestive heart failure was 26.0 +/- 34.3 days. The mean heart rate on admission was 156.3 +/- 28.7 beats/min. All patients had severe heart failure with a NYHA functional class of 2.3 +/- 0.5, left ventricular ejection fraction of 0.32 +/- 0.10, and brain natriuretic peptide level of 505.7 +/- 449.1 pg/mL. In all patients, cardiac dysfunction recovered after 53.5 +/- 61.3 days. During the follow-up of 53 +/- 24 months, 2 patients had a recurrence of heart failure with uncontrolled tachyarrhythmia and 1 patient died suddenly.In tachycardia-induced cardiomyopathy, recurrent heart failure with uncontrollable tachyarrhythmia and sudden death were observed after recovery from cardiac dysfunction. A substrate for heart failure and/or life-threatening arrhythmia might persist, and careful, long-term follow-up seems required.