Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America; Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States of America.
Prog Cardiovasc Dis. 2019 May-Jun;62(3):212-216. doi: 10.1016/j.pcad.2019.04.001. Epub 2019 Apr 17.
Hypertrophic cardiomyopathy (HCM) is a form of inherited cardiomyopathy. Most individuals with HCM experience minimal symptoms throughout their lifetime. However, those with HCM are at risk of ventricular arrhythmias and sudden cardiac death (SCD), the most feared complication of HCM. Implantable cardioverter defibrillator (ICD) implantation has played a large role in transforming this disease from one with an ominous prognosis to one with mortality rates that are on par with the general public. Since the early 2000s, balance between SCD prevention and unnecessary ICD placement has been sought, this is reflected in the evolution of SCD risk stratification models for patients with HCM. This review discusses key concepts pertaining to HCM, with emphasis on prevention of SCD, and summarizes and compares the recommendations for ICD implantation in current guidelines.
肥厚型心肌病(HCM)是一种遗传性心肌病。大多数 HCM 患者一生中都只有轻微的症状。然而,HCM 患者存在发生室性心律失常和心源性猝死(SCD)的风险,这是 HCM 最可怕的并发症。植入式心脏复律除颤器(ICD)的植入在改变这种疾病的预后方面发挥了重要作用,使其死亡率与普通人群相当。自 21 世纪初以来,人们一直在努力寻求 SCD 预防和不必要的 ICD 放置之间的平衡,这反映在 HCM 患者 SCD 风险分层模型的演变中。本文讨论了与 HCM 相关的关键概念,重点是预防 SCD,并总结和比较了当前指南中关于 ICD 植入的建议。