{"title":"根尖肥厚性心肌病患者的临床特点和长期预后。","authors":"Meng Guo, Chuanfen Liu, Jingjing Ye, Jian Liu","doi":"10.1002/ehf2.15298","DOIUrl":null,"url":null,"abstract":"<div>\n \n \n <section>\n \n <h3> Aims</h3>\n \n <p>As a special type of hypertrophic cardiomyopathy (HCM), apical HCM (ApHCM) has different clinical characteristics while its nature history and prognosis are not well recognized. We aimed to describe the characteristics and outcomes of ApHCM and identify predictors of adverse outcomes.</p>\n </section>\n \n <section>\n \n <h3> Methods</h3>\n \n <p>In this single-centre retrospective study, we included 479 patients with HCM and divided them into ApHCM and non-ApHCM groups. Clinical, electrocardiographic, echocardiographic and survival data were compared between the groups. The primary outcome was major adverse cardiac events in hospital and during follow-up. A two-sided <i>P</i>-value < 0.05 was considered statistically significant.</p>\n </section>\n \n <section>\n \n <h3> Results</h3>\n \n <p>A total of 109 ApHCM patients and 370 non-ApHCM patients were analysed and 379 patients completed the follow-up among them. The age of enrolled patients was 61.0 (50.0–69.0) years, and 289 (60.3%) were male. Compared with non-ApHCM patients, ApHCM patients were older at diagnosis [55.0 (45.0–64.0) vs. 50.0 (40.0–61.0) years, <i>P</i> = 0.006] and had less positive family history for HCM [3 (2.8%) vs. 34 (9.2%), <i>P</i> = 0.027], more electrocardiographic abnormalities [101 (92.7%) vs. 287 (77.6%), <i>P</i> < 0.001], lower brain natriuretic peptide level [135.5 (60.8–272.8) vs. 422.5 (182.8–888.2) pg/mL, <i>P</i> < 0.001] and better left ventricular ejection fraction (LVEF) [69.00 (64.00–73.87) vs. 67.00 (60.24–73.45) %, <i>P</i> = 0.048] at baseline. During a median follow-up of 5.59 (2.33–10.30) years, the primary outcome occurred less frequently in ApHCM patients [11.4% vs 27.2%; hazard ratio (HR)<sub>adj</sub> 0.360 (95% confidence interval, CI: 0.187–0.696), <i>P</i> = 0.002; log rank <i>P</i> = 0.001]. Specifically, ApHCM was characterized by fewer all-cause death (HR<sub>adj</sub> 0.545, 95% CI: 0.305–0.975; <i>P</i> = 0.041) and fatal ventricular arrhythmia or appropriate implantable cardioverter defibrillator intervention (HR<sub>adj</sub> 0.099, 95% CI: 0.013–0.724; <i>P</i> = 0.023). LVEF (HR<sub>adj</sub> 0.861, 95% CI: 0.763–0.971; <i>P</i> = 0.015) and age (HR<sub>adj</sub> 1.247, 95% CI: 1.095–1.419; <i>P</i> = 0.001) were identified as independent predictors of the composite outcome in ApHCM.</p>\n </section>\n \n <section>\n \n <h3> Conclusions</h3>\n \n <p>Patients with ApHCM may have better prognosis. LVEF and age were independent predictors of long-term outcomes in ApHCM.</p>\n </section>\n </div>","PeriodicalId":11864,"journal":{"name":"ESC Heart Failure","volume":"12 4","pages":"2887-2897"},"PeriodicalIF":3.7000,"publicationDate":"2025-04-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15298","citationCount":"0","resultStr":"{\"title\":\"Clinical characteristics and long-term outcomes in patients with apical hypertrophic cardiomyopathy\",\"authors\":\"Meng Guo, Chuanfen Liu, Jingjing Ye, Jian Liu\",\"doi\":\"10.1002/ehf2.15298\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div>\\n \\n \\n <section>\\n \\n <h3> Aims</h3>\\n \\n <p>As a special type of hypertrophic cardiomyopathy (HCM), apical HCM (ApHCM) has different clinical characteristics while its nature history and prognosis are not well recognized. We aimed to describe the characteristics and outcomes of ApHCM and identify predictors of adverse outcomes.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Methods</h3>\\n \\n <p>In this single-centre retrospective study, we included 479 patients with HCM and divided them into ApHCM and non-ApHCM groups. Clinical, electrocardiographic, echocardiographic and survival data were compared between the groups. The primary outcome was major adverse cardiac events in hospital and during follow-up. A two-sided <i>P</i>-value < 0.05 was considered statistically significant.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Results</h3>\\n \\n <p>A total of 109 ApHCM patients and 370 non-ApHCM patients were analysed and 379 patients completed the follow-up among them. The age of enrolled patients was 61.0 (50.0–69.0) years, and 289 (60.3%) were male. Compared with non-ApHCM patients, ApHCM patients were older at diagnosis [55.0 (45.0–64.0) vs. 50.0 (40.0–61.0) years, <i>P</i> = 0.006] and had less positive family history for HCM [3 (2.8%) vs. 34 (9.2%), <i>P</i> = 0.027], more electrocardiographic abnormalities [101 (92.7%) vs. 287 (77.6%), <i>P</i> < 0.001], lower brain natriuretic peptide level [135.5 (60.8–272.8) vs. 422.5 (182.8–888.2) pg/mL, <i>P</i> < 0.001] and better left ventricular ejection fraction (LVEF) [69.00 (64.00–73.87) vs. 67.00 (60.24–73.45) %, <i>P</i> = 0.048] at baseline. During a median follow-up of 5.59 (2.33–10.30) years, the primary outcome occurred less frequently in ApHCM patients [11.4% vs 27.2%; hazard ratio (HR)<sub>adj</sub> 0.360 (95% confidence interval, CI: 0.187–0.696), <i>P</i> = 0.002; log rank <i>P</i> = 0.001]. Specifically, ApHCM was characterized by fewer all-cause death (HR<sub>adj</sub> 0.545, 95% CI: 0.305–0.975; <i>P</i> = 0.041) and fatal ventricular arrhythmia or appropriate implantable cardioverter defibrillator intervention (HR<sub>adj</sub> 0.099, 95% CI: 0.013–0.724; <i>P</i> = 0.023). LVEF (HR<sub>adj</sub> 0.861, 95% CI: 0.763–0.971; <i>P</i> = 0.015) and age (HR<sub>adj</sub> 1.247, 95% CI: 1.095–1.419; <i>P</i> = 0.001) were identified as independent predictors of the composite outcome in ApHCM.</p>\\n </section>\\n \\n <section>\\n \\n <h3> Conclusions</h3>\\n \\n <p>Patients with ApHCM may have better prognosis. LVEF and age were independent predictors of long-term outcomes in ApHCM.</p>\\n </section>\\n </div>\",\"PeriodicalId\":11864,\"journal\":{\"name\":\"ESC Heart Failure\",\"volume\":\"12 4\",\"pages\":\"2887-2897\"},\"PeriodicalIF\":3.7000,\"publicationDate\":\"2025-04-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://onlinelibrary.wiley.com/doi/epdf/10.1002/ehf2.15298\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"ESC Heart Failure\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15298\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"ESC Heart Failure","FirstCategoryId":"3","ListUrlMain":"https://onlinelibrary.wiley.com/doi/10.1002/ehf2.15298","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Clinical characteristics and long-term outcomes in patients with apical hypertrophic cardiomyopathy
Aims
As a special type of hypertrophic cardiomyopathy (HCM), apical HCM (ApHCM) has different clinical characteristics while its nature history and prognosis are not well recognized. We aimed to describe the characteristics and outcomes of ApHCM and identify predictors of adverse outcomes.
Methods
In this single-centre retrospective study, we included 479 patients with HCM and divided them into ApHCM and non-ApHCM groups. Clinical, electrocardiographic, echocardiographic and survival data were compared between the groups. The primary outcome was major adverse cardiac events in hospital and during follow-up. A two-sided P-value < 0.05 was considered statistically significant.
Results
A total of 109 ApHCM patients and 370 non-ApHCM patients were analysed and 379 patients completed the follow-up among them. The age of enrolled patients was 61.0 (50.0–69.0) years, and 289 (60.3%) were male. Compared with non-ApHCM patients, ApHCM patients were older at diagnosis [55.0 (45.0–64.0) vs. 50.0 (40.0–61.0) years, P = 0.006] and had less positive family history for HCM [3 (2.8%) vs. 34 (9.2%), P = 0.027], more electrocardiographic abnormalities [101 (92.7%) vs. 287 (77.6%), P < 0.001], lower brain natriuretic peptide level [135.5 (60.8–272.8) vs. 422.5 (182.8–888.2) pg/mL, P < 0.001] and better left ventricular ejection fraction (LVEF) [69.00 (64.00–73.87) vs. 67.00 (60.24–73.45) %, P = 0.048] at baseline. During a median follow-up of 5.59 (2.33–10.30) years, the primary outcome occurred less frequently in ApHCM patients [11.4% vs 27.2%; hazard ratio (HR)adj 0.360 (95% confidence interval, CI: 0.187–0.696), P = 0.002; log rank P = 0.001]. Specifically, ApHCM was characterized by fewer all-cause death (HRadj 0.545, 95% CI: 0.305–0.975; P = 0.041) and fatal ventricular arrhythmia or appropriate implantable cardioverter defibrillator intervention (HRadj 0.099, 95% CI: 0.013–0.724; P = 0.023). LVEF (HRadj 0.861, 95% CI: 0.763–0.971; P = 0.015) and age (HRadj 1.247, 95% CI: 1.095–1.419; P = 0.001) were identified as independent predictors of the composite outcome in ApHCM.
Conclusions
Patients with ApHCM may have better prognosis. LVEF and age were independent predictors of long-term outcomes in ApHCM.
期刊介绍：
ESC Heart Failure is the open access journal of the Heart Failure Association of the European Society of Cardiology dedicated to the advancement of knowledge in the field of heart failure. The journal aims to improve the understanding, prevention, investigation and treatment of heart failure. Molecular and cellular biology, pathology, physiology, electrophysiology, pharmacology, as well as the clinical, social and population sciences all form part of the discipline that is heart failure. Accordingly, submission of manuscripts on basic, translational, clinical and population sciences is invited. Original contributions on nursing, care of the elderly, primary care, health economics and other specialist fields related to heart failure are also welcome, as are case reports that highlight interesting aspects of heart failure care and treatment.
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