Bieczek Dominika, Ściślicka Adrianna, Adamiec Agnieszka, Cader Aleksandra, Wandasiewicz Monika, Basiaga Bartosz, Niemiec Małgorzata, Mizia-Stec Katarzyna
Students' Scientific Society, First Department of Cardiology, Medical University of Silesia, 40-635 Katowice, Poland.
Centre of the European Reference Network for Rare, Low Prevalence, or Complex Diseases of the Heart (ERN GUARD Heart), 1105 AZ Amsterdam, The Netherlands.
J Clin Med. 2024 Sep 4;13(17):5239. doi: 10.3390/jcm13175239.
: Regardless of genetic origin and recommended screening methods, hypertrophic cardiomyopathy (HCM) is commonly diagnosed late in the advanced stages of the disease. The aim of this study was to analyse the case history of patients with HCM in order to obtain an initiation of the diagnostic process. : This study was a retrospective, tertiary, single-centre cohort analysis of 85 consecutive pts with HCM (mean age at the time of HCM diagnosis: 51 ± 15 years; F/M: 42/43) who were hospitalized during the period from 1 January 2013 to 31 December 2022. Type of referral to the hospital, the reason for hospitalization as well as accompanying symptoms, comorbidities, and family history were analysed to obtain an initiation of the diagnostic process. The analysis was limited to hospitalizations in which the diagnosis of HCM was stated for the first time. : An analysis of the type of referral to the hospital revealed the following data: 18% of patients were admitted as urgent hospitalizations (UHs) and 82% as elective hospitalizations (EHs). Among the UHs, the majority of patients were transferred from another hospital (13%), and among the EHs, 65% of patients were referred from a specialised outpatient medical care (SMC) facility. The majority of patients in both the UH and EH groups were symptomatic: 84% in the EH group (the most common symptom was exertional dyspnea in 56% of pts) and 93% in the UH group (the most common symptom was syncope in 60% of pts). Among the analysed population, the most frequent comorbidities were systemic hypertension (51%), lipid metabolism disorders (38%) and obesity (23%). : A diagnosis of HCM is often made at an advanced age in symptomatic patients, mainly during an EH. Nearly one-fifth of the Polish HCM population is diagnosed during a UH after a sudden event, which suggests the need for improvements in medical care in Poland.
无论遗传起源和推荐的筛查方法如何,肥厚型心肌病(HCM)通常在疾病晚期才被诊断出来。本研究的目的是分析HCM患者的病历,以便启动诊断过程。 本研究是一项回顾性、三级、单中心队列分析,研究对象为2013年1月1日至2022年12月31日期间住院的85例连续HCM患者(HCM诊断时的平均年龄:51±15岁;女性/男性:42/43)。分析了转诊至医院的类型、住院原因以及伴随症状、合并症和家族史,以启动诊断过程。分析仅限于首次诊断为HCM的住院病例。 对转诊至医院的类型进行分析,结果如下:18%的患者作为紧急住院(UH)入院,82%作为择期住院(EH)入院。在UH患者中,大多数患者是从另一家医院转诊而来(13%),在EH患者中,65%的患者是从专科门诊医疗(SMC)机构转诊而来。UH组和EH组的大多数患者都有症状:EH组为84%(最常见症状是56%的患者出现劳力性呼吸困难),UH组为93%(最常见症状是60%的患者出现晕厥)。在分析的人群中,最常见的合并症是系统性高血压(51%)、脂质代谢紊乱(38%)和肥胖(23%)。 HCM的诊断通常在有症状的患者高龄时做出,主要是在EH期间。波兰近五分之一的HCM患者是在突发事件后作为UH被诊断出来的,这表明波兰的医疗保健需要改进。