Marrakchi S, Kammoun I, Bennour E, Laroussi L, Kachboura S
Department of Cardiology, Abderrahmane Mami Hospital, Ariana, Tunisia.
El Manar University, 8, Rue Zohra Touati El Manar 1, Tunis, 2092, Tunisia.
Herz. 2020 Feb;45(1):50-64. doi: 10.1007/s00059-018-4700-8. Epub 2018 Apr 25.
Sudden cardiac death (SCD) is the most devastating complication of hypertrophic cardiomyopathy (HCM). The greatest challenge in the management of HCM is identifying those at increased risk, since an implantable cardioverter-defibrillator (ICD) is a potentially life-saving therapy. We sought to summarize the available data on SCD in HCM and provide a clinical perspective on the current differing and somewhat conflicting data on risk stratification, with balanced guidance regarding rational clinical decision-making. Additionally, we sought to determine the status of the current implementation of guidelines compiled by HCM experts worldwide. The HCM Risk-SCD model helps improve the risk stratification of HCM patients for primary prevention of SCD by calculating an individual risk estimate that contributes to the clinical decision-making process. Improved risk stratification is important for decision-making before ICD implantation for the primary prevention of SCD.
心源性猝死（SCD）是肥厚型心肌病（HCM）最具毁灭性的并发症。HCM治疗中最大的挑战是识别那些风险增加的患者，因为植入式心脏复律除颤器（ICD）是一种可能挽救生命的治疗方法。我们试图总结HCM中SCD的现有数据，并就目前关于风险分层的不同且有些相互矛盾的数据提供临床观点，同时提供关于合理临床决策的平衡指导。此外，我们试图确定全球HCM专家编制的指南的当前实施状况。HCM风险-SCD模型通过计算有助于临床决策过程的个体风险估计值，有助于改善HCM患者SCD一级预防的风险分层。改善风险分层对于ICD植入前SCD一级预防的决策很重要。
