肥厚型心肌病患者的体重减轻：临床病例系列
Weight loss in hypertrophic cardiomyopathy: A clinical case series.
作者信息
Reuter Maria C, Massera Daniele, Axel Leon, Latson Larry A, Goldstein Jonathan M, Stepanovic Alexandra, Sherrid Mark V
机构信息
Hypertrophic Cardiomyopathy Program, The Leon H. Charney Division of Cardiology, NYU Langone Health, New York, NY, USA.
NYU Radiology Associates, NYU Langone Health, New York, NY, USA.
出版信息
Int J Cardiol Cardiovasc Risk Prev. 2023 Feb 26;17:200179. doi: 10.1016/j.ijcrp.2023.200179. eCollection 2023 Jun.
BACKGROUND
Obesity is prevalent among patients with hypertrophic cardiomyopathy (HCM). Obese HCM patients have greater wall thickness, LV mass, worse hemodynamic function and NYHA class. Weight loss may favorably influence the HCM phenotype.
CASE SUMMARY
We describe six patients with hypertrophic cardiomyopathy who lost weight through diet and lifestyle changes (n = 4) or bariatric surgery (n = 2). Radiographic imaging, with cardiac MRI or CT scan, was performed before and after their weight loss. There was a mean decrease in LV mass and indexed LV mass, and a mean numerical decrease in mean wall thickness in up to 14 out of 18 LV segments. There was also NYHA class reduction in symptoms.
DISCUSSION
In this case series, we have shown that substantial weight loss in HCM patients can be associated with a decrease in LV mass, wall thickness and improvement in symptoms. These observations indicate the potential for positive remodeling of the heart by weight loss. Prospective studies of the benefits of weight loss in HCM are needed.
背景
肥胖在肥厚型心肌病（HCM）患者中很常见。肥胖的HCM患者有更大的室壁厚度、左心室质量、更差的血流动力学功能和纽约心脏协会（NYHA）心功能分级。体重减轻可能对HCM表型产生有利影响。
病例总结
我们描述了6例肥厚型心肌病患者，他们通过饮食和生活方式改变（n = 4）或减肥手术（n = 2）实现了体重减轻。在体重减轻前后进行了心脏磁共振成像（MRI）或计算机断层扫描（CT）的影像学检查。左心室质量和左心室质量指数平均下降，18个左心室节段中多达14个节段的平均室壁厚度有平均数值下降。症状的NYHA分级也有所降低。
讨论
在这个病例系列中，我们表明HCM患者的大量体重减轻可能与左心室质量、室壁厚度的降低以及症状的改善有关。这些观察结果表明体重减轻可能使心脏发生正向重塑。需要对HCM患者体重减轻的益处进行前瞻性研究。
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