Bunseki Kagaku最新文献

英文中文

Clinical Features of Heart Failure in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort　- Results From the Kochi RYOMA Study. 日本地区队列中肥厚型心肌病患者心力衰竭的临床特征--高知 RYOMA 研究的结果。

IF 3.1 4区化学 Q4 CHEMISTRY, ANALYTICAL

Bunseki Kagaku

Pub Date : 2022-11-25 Epub Date: 2022-06-07 DOI: 10.1253/circj.CJ-22-0068

Yuya Miyamoto, Toru Kubo, Yuri Ochi, Yuichi Baba, Takayoshi Hirota, Naohito Yamasaki, Kazuya Kawai, Katsuhito Yamamoto, Fumiaki Kondo, Kanji Bando, Eisuke Yamada, Takashi Furuno, Toshikazu Yabe, Yoshinori L Doi, Hiroaki Kitaoka

Background: The clinical features of heart failure (HF) in patients with hypertrophic cardiomyopathy (HCM) in Japan have not been fully elucidated.

Methods and results: In 293 patients with HCM (median age at registration, 65 (57-72) years) in a prospective cardiomyopathy registration network in Kochi Prefecture (Kochi RYOMA study), HF events (HF death or hospitalization for HF) occurred in 35 patients (11.9%) (median age, 76 (69-80) years), including 11 HF deaths during a median follow-up of 6.1 years. The 5-year HF events rate was 9.6%. Atrial fibrillation, low percentage of fractional shortening, and high B-type natriuretic peptide level at registration were predictors of HF events. The combination of these 3 factors had a relatively high positive predictive value (55%) for HF events and none of them had a high negative predictive value (99%). There were 4 types of HF profile: left ventricular (LV) systolic dysfunction (40%), severe LV diastolic dysfunction (34%), LV outflow tract obstruction (LVOTO) (20%), and primary mitral regurgitation (MR) (6%). HF deaths occurred in patients with LV systolic dysfunction or LV diastolic dysfunction, but none of patients with LVOTO or primary MR due to additional invasive therapies.

Conclusions: In a Japanese HCM cohort, HF was an important complication, requiring careful follow-up and appropriate treatment.

背景：日本肥厚型心肌病（HCM）患者心力衰竭（HF）的临床特征尚未完全阐明：在高知县前瞻性心肌病登记网络（高知 RYOMA 研究）的 293 名 HCM 患者（登记时的中位年龄为 65（57-72）岁）中，有 35 名患者（11.9%）（中位年龄为 76（69-80）岁）发生了高频事件（高频死亡或因高频住院），其中包括在中位随访 6.1 年期间的 11 例高频死亡。5年房颤事件发生率为9.6%。心房颤动、骨折缩短率低和登记时 B 型钠尿肽水平高是导致心房颤动事件的预测因素。这三个因素的组合对心房颤动事件的阳性预测值相对较高（55%），而没有一个因素对心房颤动事件的阴性预测值较高（99%）。心房颤动有四种类型：左心室收缩功能障碍（40%）、严重左心室舒张功能障碍（34%）、左心室流出道梗阻（20%）和原发性二尖瓣反流（6%）。有左心室收缩功能障碍或左心室舒张功能障碍的患者出现了房颤死亡，但有左心室流出道梗阻或原发性二尖瓣反流的患者均未因额外的侵入性治疗而死亡：在日本的 HCM 队列中，心房颤动是一种重要的并发症，需要仔细随访和适当治疗。

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