肥厚型梗阻性心肌病患者双腔起搏与酒精室间隔消融术的长期疗效比较。

Comparison of long-term effect of dual-chamber pacing and alcohol septal ablation in patients with hypertrophic obstructive cardiomyopathy.

作者信息

Krejci Jan, Gregor Pavel, Zemanek David, Vyskocilova Klaudia, Curila Karol, Stepanova Radka, Novak Miroslav, Groch Ladislav, Veselka Josef

机构信息

Department of Cardiovascular Diseases, St. Anne's University Hospital-International Clinical Research Center and Masaryk University, Pekařská 53, 656 91 Brno, Czech Republic.

出版信息

ScientificWorldJournal. 2013 Nov 11;2013:629650. doi: 10.1155/2013/629650. eCollection 2013.

DOI:10.1155/2013/629650

PMID:24319378

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC3844225/

Abstract

INTRODUCTION

Nonpharmacological treatment of patients with hypertrophic obstructive cardiomyopathy (HOCM) comprises surgical myectomy (SME), alcohol septal ablation (ASA), and dual-chamber (DDD) pacing. The aim of the study was to compare the long-term effect of DDD pacing and ASA in symptomatic HOCM patients.

PATIENTS AND METHODS

We evaluated retrospective data from three cardiocenters; there were 24 patients treated with DDD pacing included and 52 treated with ASA followed for 101 ± 49 and 87 ± 23 months, respectively.

RESULTS

In the group treated with DDD pacing, the left ventricle outflow tract gradient (LVOTG) decreased from 82 ± 44 mmHg to 21 ± 21 mmHg, and NYHA class improved from 2.7 ± 0.5 to 2.1 ± 0.6 (both P < 0.001). In the ASA-treated group, a decline in LVOTG from 73 ± 38 mmHg to 24 ± 26 mmHg and reduction in NYHA class from 2.8 ± 0.5 to 1.7 ± 0.8 were observed (both P < 0.001). The LVOTG change was similar in both groups (P = 0.264), and symptoms were more affected by ASA (P = 0.001).

CONCLUSION

ASA and DDD pacing were similarly effective in reducing LVOTG. The symptoms improvement was more expressed in patients treated with ASA.

摘要

引言

肥厚性梗阻性心肌病（HOCM）患者的非药物治疗包括外科心肌切除术（SME）、酒精室间隔消融术（ASA）和双腔（DDD）起搏。本研究的目的是比较DDD起搏和ASA对有症状的HOCM患者的长期疗效。

患者与方法

我们评估了来自三个心脏中心的回顾性数据；其中包括24例接受DDD起搏治疗的患者和52例接受ASA治疗的患者，分别随访了101±49个月和87±23个月。

结果

在接受DDD起搏治疗的组中，左心室流出道压差（LVOTG）从82±44mmHg降至21±21mmHg，纽约心脏协会（NYHA）心功能分级从2.7±0.5改善至2.1±0.6（均P<0.001）。在接受ASA治疗的组中，观察到LVOTG从73±38mmHg降至24±26mmHg，NYHA心功能分级从2.8±0.5降至1.7±0.8（均P<0.001）。两组的LVOTG变化相似（P = 0.264），而ASA对症状的影响更大（P = 0.001）。