Cardiology Department, University General Hospital of Ciudad Real, Spain.
Inherited Cardiac Diseases Unit, Cardiology Department, University General Hospital of Ciudad Real, Spain.
Rev Port Cardiol (Engl Ed). 2021 Mar;40(3):221-223. doi: 10.1016/j.repc.2020.08.012. Epub 2021 Jan 21.
According to current international guidelines, hypertrophic cardiomyopathy (HCM) patients should be managed in specialized units. However, there is lack of data on the impact of the creation of these units in the management of HCM patients. Our goal was to assess the impact of the creation of an Inherited Inherited Diseases Cardiac Unit (ICDU) in the current management of patients with HCM.
We analyzed 114 consecutive patients (62.6±8 years old, 70.2% males) with HCM. Variables related to optimal management of HCM patients and their family study were recorded, as well as guidance on the risk of sudden death. We analyzed whether patients were assessed by the ICDU or at a general cardiology consultation (GCC).
50 patients were assessed in the IDCU and 64 in the GCC. Familial screening was more frequent in patients assessed by the IDCU (45.3% vs. 4%; p<0.01), requesting more genetic studies of the index case (70.3% vs. 14%; p<0.01) and cardiac magnetic resonance (53.1% vs. 18%; p<0.01). Sudden death risk score was performed more frequently in patients after the creation of an IDCU (67.2% vs. 28%; p<0.01). Treatment with beta-blockers was similar in both groups (72% vs. 78.1%; p=0.24). An implantable cardiac defibrillator was indicated similarly in both groups (12.5% in ICDU and 6% in GC; p=0.24).
The implementation of an IDCU improved the quality of the medical care for HCM patients by performing a better study of the patients and their families.
根据当前的国际指南,肥厚型心肌病(HCM)患者应在专门的单位进行管理。然而,关于创建这些单位对 HCM 患者管理的影响的数据尚缺乏。我们的目标是评估创建遗传性疾病心脏病学单位(ICDU)对 HCM 患者当前管理的影响。
我们分析了 114 例连续的 HCM 患者(62.6±8 岁,70.2%为男性)。记录了与 HCM 患者的最佳管理及其家族研究相关的变量,以及对猝死风险的指导。我们分析了患者是由 ICDU 还是普通心脏病学咨询(GCC)评估的。
50 例患者在 ICDU 评估,64 例在 GCC 评估。在 ICDU 评估的患者中,家族筛查更为频繁(45.3% vs. 4%;p<0.01),请求对索引病例进行更多的基因研究(70.3% vs. 14%;p<0.01)和心脏磁共振(53.1% vs. 18%;p<0.01)。在创建 ICDU 后,更多的患者进行了猝死风险评分(67.2% vs. 28%;p<0.01)。两组患者β受体阻滞剂的治疗相似(72% vs. 78.1%;p=0.24)。两组均相似地指示植入式心脏除颤器(ICDU 中为 12.5%,GC 中为 6%;p=0.24)。
实施 ICDU 通过更好地研究患者及其家属,提高了 HCM 患者的医疗质量。