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首页> 外文期刊>Cardiology Journal >Late gadolinium enhancement is common in patients with hypertrophic cardiomyopathy and no clinical risk factors for sudden cardiac death: A single center experience
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Late gadolinium enhancement is common in patients with hypertrophic cardiomyopathy and no clinical risk factors for sudden cardiac death: A single center experience

机译：肥大型心肌病患者常见晚期增强，且无临床危险因素导致心脏猝死：单中心经验

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Background: Cardiac magnetic resonance (CMR) is used in the diagnosis and risk stratification of hypertrophic cardiomyopathy (HCM) and can detect myocardial replacement fibrosis (anindependent predictor of adverse cardiac outcomes) using late gadolinium enhancement (LGE).Methods: We retrospectively analysed CMR studies carried out over a 2 year period identifying those which were diagnostic of HCM. 117 cases were analysed. Mean age of subjects was 53 years and 78 (67%) were male. Mean ejection fraction (EF) was 68.3% with a mean left ventricular (LV) mass index of 89.4 g/m2. Hypertrophy was predominantly asymmetric in 94 (80%).Results: All subjects received gadolinium and 80 (68%) had evidence of LGE. LVEF was lower (67 vs. 71%; p = 0.015) and LV mass index higher (94 vs. 81 g/m2; p = 0.007) in the LGE group. The proportion of patients with at least 1 clinical risk factor for sudden cardiac death (SCD) was similar in groups with and without LGE (48% vs. 32%; p = 0.160). In this study, a significant proportion (62%) of patients without clinical risk factors for SCD were found to have LGE on CMR. These patients would not currently be considered for therapy with an implantable cardiac defibrillator.Conclusions: 1. Patients with HCM are at increased risk of SCD, but identifying patients who may benefit from implantable defibrillators is difficult. 2. LGE is associated with adverse cardiovascular outcomes in HCM, but is present in a large proportion of patients. 3. Many patients without clinical risk factors for SCD have LGE and would not currently be considered for an implantable cardiac device.
机译：背景：心脏磁共振（CMR）用于肥厚型心肌病（HCM）的诊断和风险分层，并且可以使用晚期g增强（LGE）检测心肌替代性纤维化（不良心脏预后的独立预测因子）方法：我们回顾性分析了CMR在为期2年的研究中，确定了可诊断HCM的那些。分析了117例。受试者的平均年龄为53岁，其中78位（67％）为男性。平均射血分数（EF）为68.3％，平均左心室（LV）质量指数为89.4 g / m 2 。 94例（80％）的患者肥大主要为不对称。结果：所有受试者均接受g治疗，其中80例（68％）有LGE证据。 LGE组的LVEF较低（67％vs. 71％; p = 0.015），LV质量指数较高（94％vs. 81 g / m 2 ; p = 0.007）。有或没有LGE的患者中，至少有1种临床危险因素导致的心源性猝死（SCD）的患者比例相似（48％比32％; p = 0.160）。在这项研究中，发现无SCD临床危险因素的患者中有很大一部分（62％）在CMR上患有LGE。结论：1. HCM患者罹患SCD的风险增加，但是很难确定可能从植入式除颤器中受益的患者。 2. LGE与HCM的不良心血管预后有关，但在大多数患者中都存在。 3.许多没有SCD临床危险因素的患者患有LGE，因此目前不考虑使用可植入心脏设备。

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