诊断和治疗高伤心肌病的诊断和治疗
Maximilian N Möbius-Winkler1, Ulrich Laufs, Karsten Lenk
1Clinic and Polyclinic for Cardiology, Universitätsklinikum Leipzig.
Deutsches Arzteblatt international
|October 8, 2024
概括
超性心肌病 (HCM) 管理包括药物治疗症状患者的左心室外流通道 (LVOT) 的高梯度. 早期诊断和遵循指南的治疗可以使HCM患者的预期寿命接近正常.
科学领域:
- 心脏病学 心脏病学
- 遗传学 是一个遗传学.
- 心肌疾病 心肌疾病
背景情况:
- 增高性心肌病变 (HCM) 是一种常见的心肌病,影响1:500个个体.
- 由于心肌厚的特征,HCM诊断包括临床评估,遗传研究,心声学和心脏MRI.
- 在得到最佳治疗的情况下,HCM的年死亡率低于1%.
研究的目的:
- 审查目前对高伤心肌病 (HCM) 的诊断和治疗策略.
- 突出药物治疗选择和新兴的治疗方法与左心室外流通道 (LVOT) 阻塞的HCM.
- 强调符合指导方针的管理对患者结果的重要性.
主要方法:
- 对相关出版物的选择性文献搜索.
- 包括目前诊断和治疗的临床指南.
- 对药物治疗和干预治疗的证据的审查.
主要成果:
- 用β-阻断剂或通道抗剂的药物治疗是高LVOT梯度 (≥50毫米血) 的症状患者的第一线治疗.
- 马瓦卡门,一种肌抑制剂,是一种新兴的治疗选择,可以降低LVOT梯度并改善生活质量.
- 如果药物治疗是无效的,则应考虑 Septal 减小疗法;像心律失常这样的后续症状的管理至关重要.
结论:
- 早期诊断和基于指南的HCM治疗可以导致接近正常的预期寿命.
- 目前对HCM和高压阻塞性心肌病 (HOCM) 的治疗策略需要进一步调查.
- 需要随机临床试验和定义的终点来推进HCM治疗.
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