Khaled Sheeren, Babateen Emad M, Alhodian Faisal Y, AlQashqari Renad W, AlZaidi Reema S, Almaimani Hala, Alharbi Nadin A, Samarin Kawlah E, Fallatah Amani A, Shalaby Ghada
Cardiology, Cardiac Center, King Abdullah Medical City, Makkah, SAU.
Cardiology, Faculty of Medicine, Benha University, Benha, EGY.
Cureus. 2021 Oct 26;13(10):e19054. doi: 10.7759/cureus.19054. eCollection 2021 Oct.
Background There are few reports on the prevalence of different types of cardiomyopathy, clinical presentation, severity, short-term outcomes, and implementation of advanced heart failure treatment. This study aimed to assess the prevalence, clinical background of different types of cardiomyopathy and to identify the candidate for advanced treatment in a tertiary care cardiac center with many advantages Method A single-center retrospective cohort study included 1069 patients admitted to our center and diagnosed with cardiomyopathy during 2019 and 2020 Results Out of 1069 cardiomyopathy patients admitted and diagnosed at our center between 2019 and 2020, 62% had ischemic cardiomyopathy (ICM), 36% had dilated cardiomyopathy (DCM), and 2% had hypertrophic cardiomyopathy (HOCM). ICM patients were older, showed a higher prevalence of both male gender and pilgrims, and they had more frequent cardiovascular risk factors compared to dilated cardiomyopathy group of patients. However, DCM patients with more severe heart failure symptoms (NYHA class III/IV), much worse LVEF, were subsequently considered deemed for aggressive diuretic therapy, and further advanced therapy (Sacubitril-Valsartan and device therapy) compared to ICM patients. ICM patients showed poor in-hospital outcomes compared to DCM group of patients (0.05 and <0.001) for an indication for mechanical ventilation and in-hospital mortality, respectively). Increased age, presence of renal dysfunction and lower LVEF were found the independent predictors of in-hospital mortality among our studied patients Conclusion There are discrepancies between DCM and ICM patients. Although DCM patients were younger at age and had fewer cardiovascular risk factors, they presented with severe symptoms and dysfunction, hence more eligible candidates for advanced heart failure treatment, and finally showed a lower mortality rate. Increased age, presence of renal dysfunction and lower LVEF were found the independent predictors of in-hospital mortality.
关于不同类型心肌病的患病率、临床表现、严重程度、短期预后以及晚期心力衰竭治疗的实施情况的报道较少。本研究旨在评估不同类型心肌病的患病率、临床背景，并在具有诸多优势的三级心脏护理中心确定晚期治疗的候选对象。方法：一项单中心回顾性队列研究纳入了2019年至2020年期间入住本中心并被诊断为心肌病的1069例患者。结果：在2019年至2020年期间入住并在本中心被诊断为心肌病的1069例患者中，62%患有缺血性心肌病（ICM），36%患有扩张型心肌病（DCM），2%患有肥厚型心肌病（HOCM）。ICM患者年龄较大，男性和朝圣者的患病率较高，与扩张型心肌病患者组相比，他们有更频繁的心血管危险因素。然而，与ICM患者相比，DCM患者有更严重的心力衰竭症状（纽约心脏协会III/IV级），左心室射血分数更差，随后被认为适合积极的利尿治疗以及进一步的晚期治疗（沙库巴曲缬沙坦和器械治疗）。与DCM患者组相比，ICM患者的住院结局较差（分别为机械通气指征和住院死亡率的0.05和<0.001）。在我们研究的患者中发现，年龄增加、肾功能不全的存在和较低的左心室射血分数是住院死亡率的独立预测因素。结论：DCM和ICM患者之间存在差异。尽管DCM患者年龄较小且心血管危险因素较少，但他们表现出严重的症状和功能障碍，因此是晚期心力衰竭治疗更合适的候选对象，最终死亡率较低。年龄增加、肾功能不全的存在和较低的左心室射血分数是住院死亡率的独立预测因素。
