临床轨迹的NYHA功能性I类患者与阻塞性多变性心肌病变
Monica Ahluwalia1, Jiankang Liu2, Iacopo Olivotto3
1Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA; Boston Medical Center Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, USA.
JACC. Heart failure
|November 9, 2024
概括
在5年内,NYHA功能类I的阻塞性缩性心肌病 (oHCM) 患者的不良事件比II类患者少. 然而,年龄较大,女性性别和左心房直径较大增加了I类oHCM患者的风险.
科学领域:
- 心脏病学 心脏病学
- 内部医学 内部医学
- 遗传学 是一个遗传学.
背景情况:
- 在纽约心脏协会 (NYHA) 功能类I患者中,了解阻塞性多变性心肌病 (oHCM) 的自然史至关重要.
- 萨尔科默里克人类心肌病学注册表 (SHaRe) 为此类调查提供了有价值的数据.
研究的目的:
- 描述在NYHA功能类I患者中oHCM的自然史.
- 为了比较NYHA类I和类IIoHCM患者之间的结果.
- 为了确定与NYHA类I oHCM患者临床事件相关的基线特征.
主要方法:
- 使用了一个多中心注册表 (SHaRe).
- 在NYHA功能类I中的oHCM患者与NYHA功能类II中的患者进行了比较.
- 事件临床事件包括症状恶化,弹射率降低,心律失常,中风,干预或死亡.
- 统计模型包括卡普兰-梅尔,考克斯比例危险和受限立方线分析.
主要成果:
- 在1,239名oHCM患者中,598人是NYHA I级,641人是NYHA II级.
- 5年复合事件率为NYHA类I的28%,而NYHA类II的44% (P<0.001).
- 在NYHA I级患者中,不良事件的风险增加与左心房直径大 (≥45毫米),女性性别和年龄较大有关.
结论:
- 具有oHCM的NYHA功能类I患者的预后比NYHA类II患者更好.
- 在NYHAI类oHCM患者中,很大一部分 (25%以上) 在5年内经历了不良事件.
- 需要有针对性的策略来缓解NYHA类I oHCM患者的临床结果,特别是那些具有特定风险因素的患者.
相关概念视频
Pathophysiology of Heart Failure
1.5K
Heart failure (HF) is a progressive syndrome involving ventricles that leads to inadequate cardiac output. It can be classified based on location and output or ejection fraction. Ejection fraction (EF) is an essential measurement in the diagnosis and surveillance of HF. Reduced EF corresponds to systolic heart failure (HFrEF). However, HF with preserved ejection fraction (HFpEF) is becoming increasingly prevalent. Also known as diastolic HF, this form of HF is related to aging. The...
1.5K
Pulmonary Hypertension: Classification and Pathogenesis
150
Pulmonary hypertension (PH) is a severe health condition in which the mean pulmonary arterial pressure increases to 25 mmHg or more, even when the body is at rest. This high pressure in the blood vessels that transport blood from the heart to the lungs can cause various symptoms, including shortness of breath, can lead to right heart failure, and significantly affect the overall quality of life.
There are various classifications for PH, each relating to different underlying causes and also...
There are various classifications for PH, each relating to different underlying causes and also...
150
Mitral Stenosis I: Introduction
2
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
2
Pathophysiology of Cardiac Performance
574
Typical heart performance is influenced by heart rate, rhythm, myocardial contraction, and metabolism or blood flow. The cardiac muscle exhibits distinct electrophysiological features, including pacemaker activity and calcium channel control, which play a vital role in the heart's response to various drugs. The autonomic nervous system, comprising the sympathetic and parasympathetic branches, regulates heart rate. Sympathetic activation increases heart rate, while parasympathetic activation...
574
Mitral Regurgitation I: Introduction
4
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
4
Myocarditis I: Introduction
2
Myocarditis is inflammation of the myocardium, which is the muscular layer of the heart.EtiologyMyocarditis has a diverse etiology, including a wide range of infectious and non-infectious causes:Infectious CausesViral: Common viruses include Coxsackie A and B, adenovirus, parvovirus B19, enteroviruses, and influenza A.Bacterial: Examples include infections caused by Streptococcus, Staphylococcus, and Mycoplasma species.Rickettsial: Infections like Rocky Mountain spotted fever can result in...
2


