Sorajja Paul, Ommen Steve R, Nishimura Rick A, Gersh Bernard J, Tajik A Jamil, Holmes David R
Division of Cardiovascular Disease and Internal Medicine, Mayo Clinic and Foundation, 200 SW First Street, Rochester, MN 55905, USA.
J Am Coll Cardiol. 2003 Sep 3;42(5):889-94. doi: 10.1016/s0735-1097(03)00854-4.
This investigation examined the risk of sudden cardiac death and other mortality in adult patients with hypertrophic cardiomyopathy (HCM) who have myocardial bridging diagnosed at coronary angiography.
Several reports have associated myocardial bridging with an adverse prognosis in pediatric HCM patients, but the prognosis of myocardial bridging in adult patients with HCM is unknown.
The coronary angiograms of 425 patients with HCM (mean age 60 +/- 15 years [range 18 to 89 years]) at the Mayo Clinic were examined for the presence of myocardial bridging. Clinical follow-up was conducted to assess mortality. Survival of patients with bridging was compared with HCM patients who also underwent angiography but who did not have evidence of bridging.
A total of 64 patients (15%) had myocardial bridging. The mean follow-up for the entire study was 6.8 +/- 5.4 years. There was no difference in survival free of all-cause mortality (5-year estimate, bridging vs. no bridging, 91% vs. 85%; p = 0.42), all cardiac death (93% vs. 89%; p = 0.60), and sudden cardiac death (95% vs. 97%; p = 0.72). Univariate and multivariate proportional hazards models also did not identify the presence of bridging or specific characteristics of the degree or extent of bridging with a poor outcome.
This study observed no increased risk of death, including sudden cardiac death, among adult patients with HCM who had myocardial bridging diagnosed at coronary angiography.
本研究调查了在冠状动脉造影时被诊断为心肌桥的肥厚型心肌病（HCM）成年患者发生心源性猝死及其他死亡的风险。
多项报告表明心肌桥与小儿HCM患者的不良预后相关，但成年HCM患者中心肌桥的预后尚不清楚。
对梅奥诊所425例HCM患者（平均年龄60±15岁[范围18至89岁]）的冠状动脉造影进行检查，以确定是否存在心肌桥。进行临床随访以评估死亡率。将有心肌桥的患者生存率与同样接受了血管造影但无心肌桥证据的HCM患者进行比较。
共有64例患者（15%）存在心肌桥。整个研究的平均随访时间为6.8±5.4年。在全因死亡率（5年估计，有心肌桥与无心肌桥分别为91%对85%；p = 0.42）、所有心源性死亡（93%对89%；p = 0.60）和心源性猝死（95%对97%；p = 0.72）方面无差异。单因素和多因素比例风险模型也未发现心肌桥的存在或心肌桥程度或范围的特定特征与不良结局相关。
本研究观察到，在冠状动脉造影时被诊断为心肌桥的成年HCM患者中，包括心源性猝死在内的死亡风险并未增加。
