O'Mahony Constantinos, Mohiddin Saidi A, Knight Charles
The Heart Muscle Disease Clinic, London Chest Hospital, London, UK.
Interv Cardiol. 2014 Apr;9(2):108-114. doi: 10.15420/icr.2011.9.2.108.
Hypertrophic cardiomyopathy (HCM) is an inherited myocardial disorder characterised by left ventricular hypertrophy. A subgroup of patients develops limiting symptoms in association with left ventricular outflow tract obstruction (LVOTO). Current international guidelines recommend that symptomatic patients are initially treated by alleviating exacerbating factors and negatively inotropic medication. Drug-refractory symptoms require a comprehensive evaluation of the mechanism of LVOTO and review by a multidisciplinary team to consider the relative merits of myectomy, alcohol septal ablation (ASA) and pacing. This article provides a brief overview of HCM and the pathophysiology of LVOTO, and reviews the use of ASA in patients with drug-refractory symptoms secondary to LVOTO.
肥厚型心肌病（HCM）是一种以左心室肥厚为特征的遗传性心肌疾病。一部分患者会出现与左心室流出道梗阻（LVOTO）相关的限制性症状。目前的国际指南建议，有症状的患者最初应通过缓解加重因素和使用负性肌力药物进行治疗。药物难治性症状需要对LVOTO的机制进行全面评估，并由多学科团队进行审查，以考虑肌切除术、酒精间隔消融术（ASA）和起搏的相对优缺点。本文简要概述了HCM和LVOTO的病理生理学，并综述了ASA在LVOTO继发药物难治性症状患者中的应用。
