Department of Cardiology, West China Hospital of Sichuan University, Chengdu, China.
Nursing Department, West China School of Nursing, West China Hospital of Sichuan University, Chengdu, China.
Int J Med Sci. 2021 Jan 1;18(3):727-735. doi: 10.7150/ijms.50167. eCollection 2021.
Hypertrophic cardiomyopathy (HCM) is an inherited cardiac disease, which has a marked heterogeneity in clinical expression, natural history, and prognosis. HCM is associated with a high prevalence of thromboembolic events (stroke and systemic embolic events), even if taking no account of atrial fibrillation (AF), leading to unexpected disability and death in patients of all ages. Several risk factors of thromboembolism such as AF, greater age, left atrial diameter, heart failure and others have been confirmed in patients with HCM. Conventional thromboembolic predictive models were estimated by several trials in HCM population but it turned out to be unsatisfactory. Based on those previous explorations, researchers tried to modify or develop novel models suitable for HCM population in thromboembolism prediction. In consideration of catastrophic advent events of thromboembolism, current guidelines have recommended life-long anticoagulant therapy after a single short AF. Therefore, early identification of risk factors for thromboembolism, accurate risk stratification, timely preventive measures and aggressive management may help to avoid serious adverse thromboembolic events in HCM population.
肥厚型心肌病(HCM)是一种遗传性心脏病,其临床表现、自然病史和预后存在明显异质性。HCM 与血栓栓塞事件(中风和全身性栓塞事件)的高发率相关,即使不考虑心房颤动(AF),也会导致各年龄段患者出现意外残疾和死亡。几项血栓栓塞的风险因素,如 AF、年龄较大、左心房直径、心力衰竭等,已在 HCM 患者中得到证实。几项试验对 HCM 人群中的常规血栓栓塞预测模型进行了评估,但结果并不令人满意。基于这些先前的探索,研究人员试图修改或开发适用于 HCM 人群血栓栓塞预测的新型模型。考虑到血栓栓塞灾难性事件的发生,目前的指南建议在单次短暂 AF 后终身抗凝治疗。因此,早期识别血栓栓塞的危险因素,准确的风险分层,及时的预防措施和积极的管理可能有助于避免 HCM 人群中严重的不良血栓栓塞事件。