Abinader Edward G, Sharif Dawod, Shefer Arie, Naschitz Johanan
Heart Institute, Bnai Zion Medical Center, and Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Isr Med Assoc J. 2002 Mar;4(3):166-9.
Long-term follow-up in apical hypertrophic cardiomyopathy is rare.
To study the natural history of the disease.
We followed 11 patients, 5 women and 6 men, for 5-20 years.
At presentation all 11 patients had typical features of apical hypertrophic cardiomyopathy, with dyspnea in 3 and chest pains in 8, of whom 5 were typical of angina and 3 had myocardial infarction. R-wave voltage and T-wave negativity progressively decreased in magnitude at serial electrocardiograms in four patients. Perfusion defects were detected on thallium myocardial scintigraphy in three, increased apical uptake in two, and normal in one patient. Apical aneurysm with normal coronary arteries developed in a patient who had sustained ventricular tachycardia. All of the 10 catheterized patients had normal coronaries except for one with significant left anterior descending artery stenosis and another with a minor lesion. Symptomatic sustained ventricular tachycardia was found in two patients, one of whom required the implantation of an internal cardioverter defibrillator.
Apical hypertrophic cardiomyopathy may develop morphologic and electrocardiographic changes with life-threatening arrhythmias necessitating close follow-up and treatment.
心尖肥厚型心肌病的长期随访较为罕见。
研究该疾病的自然病史。
我们对11例患者进行了5至20年的随访，其中5例女性，6例男性。
就诊时，所有11例患者均有典型的心尖肥厚型心肌病特征，3例有呼吸困难，8例有胸痛，其中5例为典型心绞痛，3例有心肌梗死。4例患者的系列心电图检查显示R波电压和T波倒置程度逐渐降低。3例患者在铊心肌闪烁扫描中检测到灌注缺损，2例心尖摄取增加，1例正常。1例发生持续性室性心动过速的患者出现了冠状动脉正常的心尖动脉瘤。10例接受心导管检查的患者中，除1例左前降支严重狭窄和另1例有轻微病变外，其余冠状动脉均正常。2例患者出现有症状的持续性室性心动过速，其中1例需要植入体内心脏复律除颤器。
心尖肥厚型心肌病可能会出现形态学和心电图改变，并伴有危及生命的心律失常，需要密切随访和治疗。
