Centre de Référence des Maladies Cardiaques Héréditaires, Assistance Publique-Hôpitaux de Paris, ICAN, Hôpital Pitié-Salpêtrière, 47 Bvd de l'hôpital, 75013 Paris, France.
Université Versailles Saint Quentin & AP-HP, CESP, INSERM U1018, Hôpital Ambroise Paré, 9, Avenue Charles de Gaulle, 92100 Boulogne-Billancourt, France.
Eur Heart J. 2018 May 21;39(20):1784-1793. doi: 10.1093/eurheartj/ehx819.
The Cardiomyopathy Registry of the EURObservational Research Programme is a prospective, observational, and multinational registry of consecutive patients with four cardiomyopathy subtypes: hypertrophic cardiomyopathy (HCM), dilated cardiomyopathy (DCM), arrhythmogenic right ventricular cardiomyopathy (ARVC), and restrictive cardiomyopathy (RCM). We report the baseline characteristics and management of adults enrolled in the registry.
A total of 3208 patients were enrolled by 69 centres in 18 countries [HCM (n = 1739); DCM (n = 1260); ARVC (n = 143); and RCM (n = 66)]. Differences between cardiomyopathy subtypes (P < 0.001) were observed for age at diagnosis, history of familial disease, history of sustained ventricular arrhythmia, use of magnetic resonance imaging or genetic testing, and implantation of defibrillators. When compared with probands, relatives had a lower age at diagnosis (P < 0.001), but a similar rate of symptoms and defibrillators. When compared with the Long-Term phase, patients of the Pilot phase (enrolled in more expert centres) had a more frequent rate of familial disease (P < 0.001), were more frequently diagnosed with a rare underlying disease (P < 0.001), and more frequently implanted with a defibrillator (P = 0.023). Comparing four geographical areas, patients from Southern Europe had a familial disease more frequently (P < 0.001), were more frequently diagnosed in the context of a family screening (P < 0.001), and more frequently diagnosed with a rare underlying disease (P < 0.001).
By providing contemporary observational data on characteristics and management of patients with cardiomyopathies, the registry provides a platform for the evaluation of guideline implementation. Potential gaps with existing recommendations are discussed as well as some suggestions for improvement of health care provision in Europe.
EURObservational Research Programme 的心肌病注册研究是一项前瞻性、观察性和多国注册研究,纳入了肥厚型心肌病(HCM)、扩张型心肌病(DCM)、致心律失常性右心室心肌病(ARVC)和限制型心肌病(RCM)这四种心肌病亚型的连续患者。我们报告了该注册研究中纳入的成年患者的基线特征和治疗情况。
该研究共纳入了来自 18 个国家的 69 个中心的 3208 名患者[HCM(n=1739);DCM(n=1260);ARVC(n=143);RCM(n=66)]。在诊断年龄、家族病史、持续性室性心律失常史、磁共振成像或基因检测的使用以及除颤器的植入等方面,不同心肌病亚型之间存在差异(P<0.001)。与先证者相比,亲属的诊断年龄较低(P<0.001),但症状和除颤器的发生率相似。与长期阶段相比,试点阶段(纳入了更多专家中心)的患者家族疾病的发生率更高(P<0.001),更常被诊断为罕见潜在疾病(P<0.001),更常植入除颤器(P=0.023)。比较四个地理区域,来自南欧的患者更常发生家族疾病(P<0.001),更常在家族筛查的背景下被诊断(P<0.001),更常被诊断为罕见的潜在疾病(P<0.001)。
该注册研究提供了有关心肌病患者特征和治疗的当代观察性数据,为评估指南的实施提供了一个平台。还讨论了与现有建议存在的潜在差距,并提出了一些改善欧洲医疗保健服务的建议。