Mayo Clinic Arizona, Scottsdale, Arizona, USA.
Am J Cardiol. 2010 Nov 1;106(9):1313-6. doi: 10.1016/j.amjcard.2010.06.061. Epub 2010 Sep 9.
This report describes a series of symptomatic patients with obstructive hypertrophic cardiomyopathy with significant postprandial hemodynamic changes. This finding was identified by history, clinical examination, and echocardiography in 6 consecutive symptomatic patients referred for the evaluation of ventricular septal reduction therapy. Counseling these patients with dietary changes to include small frequent meals and to increase noncaffeinated fluid intake resulted in reductions in symptoms. In conclusion, severe symptoms in obstructive hypertrophic cardiomyopathy unresponsive to pharmacologic treatment frequently result in referral for definitive septal reduction therapy through surgery or, less frequently, alcohol septal ablation therapy. However, recognition of postprandial exacerbation in symptomatic patients may allow for nonpharmacologic dietary interventions that may obviate the need for more invasive therapies and their associated complications.
本报告描述了一系列有症状的梗阻性肥厚型心肌病患者，这些患者存在明显的餐后血流动力学变化。在连续 6 例因室间隔减少治疗评估而转介的有症状患者中，通过病史、临床检查和超声心动图发现了这一发现。通过饮食改变来咨询这些患者，包括少吃多餐和增加无咖啡因的液体摄入，可减轻症状。总之，梗阻性肥厚型心肌病的严重症状对药物治疗无反应，常导致通过手术进行明确的室间隔减少治疗，或者较少见的，通过酒精室间隔消融治疗。然而，对有症状患者餐后恶化的认识可能允许进行非药物饮食干预，从而避免更具侵入性的治疗及其相关并发症的需要。
