Lee Cheng-Han, Liu Ping-Yen, Lin Li-Jen, Chen Jyh-Hong, Tsai Liang-Miin
Department of Internal Medicine, School of Medicine, National Cheng Kung University Hospital, Tainan, Taiwan, ROC.
Cardiology. 2006;106(1):29-35. doi: 10.1159/000092590. Epub 2006 Apr 7.
The aim of this study was to analyze clinical characteristics and the outcome of patients with apical hypertrophic cardiomyopathy (ApHCM) followed in a Taiwan tertiary referral medical center.
ApHCM is regarded as a subgroup of nonobstructive HCM that occurs largely in Japanese patients. The clinical features, gender differences and prognosis of the disease in Taiwan are poorly understood.
A retrospective cohort study with 40 patients was performed. Diagnosis was based on the demonstration of left ventricular hypertrophy by echocardiography. Clinical features, cardiovascular morbidity and mortality were analyzed. Multiple logistic regression was used to adjust for potential confounding factors.
Among 40 patients, males predominated with a percentage of 75%. The female patients obviously had later onset of presentation (mean age +/- SD, 62.2 +/- 5.7 vs. 54.1 +/- 11.4 years; p = 0.038). During a mean follow-up of 72.2 +/- 60.1 months, there was no mortality. However, 13 patients (32.5%) had one or more major cardiovascular morbidities, the most frequent being syncope or near syncope (15%) and ischemic stroke-associated atrial fibrillation (10%). In a multivariate analysis, left atrial enlargement (odds ratio 5.85, 95% CI 1.15-29.40; p = 0.034) was the only predictor of cardiovascular morbidity.
Patients with ApHCM in Taiwan have a benign clinical course without association with sudden death and cardiovascular mortality. Left atrial enlargement was the only identified predictor of cardiovascular morbidity
本研究旨在分析台湾一家三级转诊医疗中心收治的肥厚型心肌病（ApHCM）患者的临床特征及预后。
ApHCM被视为非梗阻性肥厚型心肌病的一个亚组，主要发生在日本患者中。台湾地区该疾病的临床特征、性别差异及预后尚不清楚。
进行了一项纳入40例患者的回顾性队列研究。诊断基于超声心动图显示的左心室肥厚。分析临床特征、心血管疾病发病率及死亡率。采用多元逻辑回归分析来调整潜在的混杂因素。
40例患者中男性占主导，比例为75%。女性患者发病明显较晚（平均年龄±标准差，62.2±5.7岁 vs. 54.1±11.4岁；p = 0.038）。在平均72.2±60.1个月的随访期间，无死亡病例。然而，13例患者（32.5%）发生了一种或多种主要心血管疾病，最常见的是晕厥或接近晕厥（15%）以及与缺血性卒中相关的心房颤动（10%）。在多因素分析中，左心房扩大（比值比5.85，95%可信区间1.15 - 29.40；p = 0.034）是心血管疾病发病的唯一预测因素。
台湾地区的ApHCM患者临床病程良性，与猝死和心血管死亡无关。左心房扩大是唯一确定的心血管疾病发病预测因素
