AMIODARONE THERAPY IN PATIENTS WITH HCM AND REFRACTORY CARDIAC SYMPTOMS

一项正在进行的临床试验已经制定，以评估 口服胺碘酮治疗慢性乙型肝炎的疗效观察 肥厚型心肌病和难治性心脏病 症状或突发心脏病风险高的患者 死亡 在过去一年，我们完成了一项研究， 现纳入72例肥厚型心肌病患者（41 加或减14年）作为两项议定书的一部分：第1组- 难治性心脏症状患者（n=50）和第2组- 猝死高危患者（n=22）。 尽管 第1组患者的症状改善， 随访期间，第1组和第2组患者的心律失常 在662 ± 273天内，8例患者发生了突发性心脏病， 死亡（累积存活率=88%）。 突然死亡似乎 在患者开始胺碘酮治疗后早期发生 严重的心脏症状，后来在高血压患者 心源性猝死的风险变量。 不幸的是我们 结论是胺碘酮不能预防并可能增加 心脏性猝死患者的某些子集 肥厚型心肌病

An ongoing clinical trial has been formulated to assess the therapeutic efficacy of oral amiodarone in patients with hypertrophic cardiomyopathy and either refractory cardiac symptoms or patients who are at high risk for sudden cardiac death. Over the past year, we have completed a study which now includes 72 patients with hypertrophic cardiomyopathy (41 plus or minus 14 years) as part of two protocols: Group 1 - patients with refractory cardiac symptoms (n=50) and Group 2 - patients who are at high risk for sudden death (n=22). Despite improved symptoms in Group 1 patients, and reduced ventricular arrhythmias in Group 1 and 2 patients, during the follow-up period (662plus or minus 273 days), 8 patients had sudden cardiac death (cummulative survival=88%). Sudden death appeared to occur early after instituting amiodarone treatment in patients with severe cardiac symptoms, and later in patients with high risk variables for sudden cardiac death. Unfortunately, we conclude that amiodarone does not prevent and may increase sudden cardiac death in certain subsets of patients with hypertrophic cardiomyopathy.