Kofflard M J, Waldstein D J, Vos J, ten Cate F J
Department of Cardiology, Thoraxcenter, Academic Hospital, Dijkzigt, Erasmus University, Rotterdam, The Netherlands.
Am J Cardiol. 1993 Oct 15;72(12):939-43. doi: 10.1016/0002-9149(93)91111-t.
Overall annual cardiac mortality in hypertrophic cardiomyopathy (HC) has been reported to be between 2 and 4%, although these numbers are primarily from retrospective studies of patients referred to large research institutions. A clinic population of 113 patients with HC was prospectively studied to assess cardiac mortality in the overall group and in selected subgroups commonly thought to be at high risk for sudden death. The mean age at diagnosis was 37 +/- 16 years. During follow-up, there were 11 cardiac and 2 noncardiac deaths. The annual cardiac mortality was 1% (95% confidence interval 0.2-1.8%). Because of the small number of deaths, relative risk for cardiac death was not significantly different in the presence of young age (< or = 30 years), family history of HC and sudden death, history of syncope or previous cardiac arrest, or both, ventricular tachycardia on 24-hour Holter monitoring, or septal myotomy/myectomy for refractory symptoms and outflow tract obstruction. It is concluded that HC has a relatively benign prognosis (1% annual cardiac mortality) that is 2 to 4 times less than that previously reported.
据报道，肥厚型心肌病（HC）的总体年度心脏死亡率在2%至4%之间，不过这些数据主要来自对转诊至大型研究机构的患者的回顾性研究。对113例HC患者的临床群体进行了前瞻性研究，以评估整个群体以及通常被认为猝死风险较高的特定亚组的心脏死亡率。诊断时的平均年龄为37±16岁。在随访期间，有11例心脏死亡和2例非心脏死亡。年度心脏死亡率为1%（95%置信区间0.2 - 1.8%）。由于死亡人数较少，在存在以下情况时，心脏死亡的相对风险无显著差异：年龄较小（≤30岁）、有HC和猝死家族史、有晕厥或既往心脏骤停病史、24小时动态心电图监测发现室性心动过速，或因难治性症状和流出道梗阻接受间隔肌切开术/肌切除术。结论是，HC的预后相对良好（年度心脏死亡率为1%），比先前报道的低2至4倍。
