Petto Jefferson, DE Oliveira Edna C, DE Almeida Raissa V A, DE Oliveira Alice M, DO Amaral Danielly S N, DE Pinna Júnior Bráulio J B
Bahia Social University Center, Salvador, BA, BRAZIL.
Bahiana School of Medicine and Public Health, Salvador, BA, BRAZIL.
Int J Exerc Sci. 2021 Aug 1;14(2):1018-1026. doi: 10.70252/CWHV9788. eCollection 2021.
Hypertrophic cardiomyopathy (HCM) is an autosomal dominant disease that causes myocardial remodeling. Physical exercise (PE) is a therapeutic resource used in Supervised Cardiac Rehabilitation (SCR) to improve Quality of Life (QL), reducing cardiovascular morbidity and mortality. Therefore, the aim of this study is to report how SCR using a personalized exercise prescription, promoted Reverse Myocardial Remodeling (RMR), improved functionality and QL of a patient with HCM. This is a case report of a 43-year-old sedentary female patient with a Body Mass Index (BMI) of 24.7 kg/m. The patient was diagnosed with Septal Type Asymmetric HCM. Heart Failure (HF) grade III / IV, according to the New York Heart Association (NYHA), was initially treated with 40mg of Propranolol Hydrochloride twice a day, and presented with excessive fatigue, and angina. The echocardiogram showed a final diastolic volume (FDV) of 130 ml, a final systolic volume (FSV) of 44 ml, a left ventricular mass (LVM) of 236 g, interventricular septum thickness of 14 mm, left ventricular posterior wall (LVPW) thickness of 9 mm, left atrium diameter 46 mm, left ventricular end diastolic diameter of 52mm, septum/left ventricular wall ratio of 1.55 mm, and ejection fraction (EF) of 66% (Teicholz). It was obtained as a result of decreased FDV 130 vs. 102ml, decreased FSV 44 vs. 32 ml, decreased LVM 236 vs. 201 g, increased EF 66 vs. 69%, 26% improvement in QL, and 50% reduction in the dosage of Propranolol Hydrochloride. These results suggest that a personalized SCR program is an adjuvant treatment capable of promoting RMR and improving QL and functionality in a patient with HCM.
肥厚型心肌病（HCM）是一种导致心肌重塑的常染色体显性疾病。体育锻炼（PE）是心脏康复监护（SCR）中用于改善生活质量（QL）、降低心血管发病率和死亡率的一种治疗手段。因此，本研究的目的是报告使用个性化运动处方的SCR如何促进逆向心肌重塑（RMR），改善一名HCM患者的功能和QL。这是一例43岁久坐不动的女性患者的病例报告，其体重指数（BMI）为24.7kg/m。该患者被诊断为间隔型非对称性HCM。根据纽约心脏协会（NYHA）分级，其心力衰竭（HF）为III/IV级，最初每天两次服用40mg盐酸普萘洛尔进行治疗，且出现过度疲劳和心绞痛症状。超声心动图显示舒张末期容积（FDV）为130ml，收缩末期容积（FSV）为44ml，左心室质量（LVM）为236g，室间隔厚度为14mm，左心室后壁（LVPW）厚度为9mm，左心房直径46mm，左心室舒张末期直径52mm，室间隔/左心室壁比率为1.55mm，射血分数（EF）为66%（Teicholz法）。结果显示FDV从130ml降至102ml，FSV从44ml降至32ml，LVM从236g降至201g，EF从66%升至69%，QL改善26%，盐酸普萘洛尔剂量减少50%。这些结果表明，个性化的SCR方案是一种辅助治疗方法，能够促进HCM患者的RMR，改善其QL和功能。
