Nguyen Anita, Schaff Hartzell V, Calderon-Rojas Rolando, Qrareya Mohammad N, Ommen Steve R, Dearani Joseph A, Todd Austin, Nishimura Rick A, Geske Jeffrey B
Department of Cardiovascular Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Cardiovascular Medicine, Mayo Clinic, Rochester, Minnesota, USA.
JACC Adv. 2023 Dec 13;3(1):100763. doi: 10.1016/j.jacadv.2023.100763. eCollection 2024 Jan.
Septal myectomy improves symptoms in the majority of patients with obstructive hypertrophic cardiomyopathy (HCM), but there are limited prospective data on functional outcomes after operation.
The authors investigated quality of life measures and prevalence of sexual dysfunction before and after septal myectomy for obstructive HCM.
Between January 2018 and October 2019, 436 patients underwent transaortic septal myectomy at our clinic. All patients were screened for eligibility, and 197 (45.2%) were enrolled in this prospective survey study. Patients received a questionnaire pertaining to quality of life and sexual health before and within 4 to 6 months postoperatively, and 113 (57.4%) completed the follow-up survey.
The mean age of the 54 (47.8%) women and 59 (52.2%) men was 54.7 ± 14.1 years. Quality of life, including both mental and physical components, improved significantly in both men ( < 0.001) and women ( < 0.001). Women reported mild sexual dysfunction at baseline, and following septal myectomy, they experienced significant ( < 0.05) improvement in most domains pertaining to sexual health. In men, the International Index of Erectile Function median score was 23 (IQR: 7.0-29.5), which is consistent with mild dysfunction at baseline, and there was significant improvement following surgery in young (age ≤55 years) men ( < 0.001).
Quality of life is significantly improved following septal myectomy in patients with obstructive HCM. Both women and men reported mild sexual dysfunction at baseline, and women and younger men (age ≤55 years) experienced significant improvements in sexual health.
间隔心肌切除术可改善大多数梗阻性肥厚型心肌病（HCM）患者的症状，但关于术后功能结局的前瞻性数据有限。
作者调查了梗阻性HCM患者间隔心肌切除术前、后的生活质量指标及性功能障碍患病率。
2018年1月至2019年10月，436例患者在我们诊所接受了经主动脉间隔心肌切除术。所有患者均进行了资格筛查，197例（45.2%）纳入了这项前瞻性调查研究。患者在术前及术后4至6个月内接受了一份关于生活质量和性健康的问卷，113例（57.4%）完成了随访调查。
54例（47.8%）女性和59例（52.2%）男性的平均年龄为54.7±14.1岁。生活质量，包括心理和身体方面，在男性（<0.001）和女性（<0.001）中均有显著改善。女性在基线时报告有轻度性功能障碍，间隔心肌切除术后，她们在大多数与性健康相关的领域有显著（<0.05）改善。在男性中，国际勃起功能指数中位数为23（四分位间距：7.0-29.5），这与基线时的轻度功能障碍一致，年轻（年龄≤55岁）男性术后有显著改善（<0.001）。
梗阻性HCM患者间隔心肌切除术后生活质量显著改善。男性和女性在基线时均报告有轻度性功能障碍，女性和年轻男性（年龄≤55岁）的性健康有显著改善。
