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首页> 外文期刊>The American Journal of Cardiology >Frequency and Significance of Coronary Artery Disease and Myocardial Bridging in Patients With Hypertrophic Cardiomyopathy
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Frequency and Significance of Coronary Artery Disease and Myocardial Bridging in Patients With Hypertrophic Cardiomyopathy

机译：冠状动脉疾病的频率和意义和心肌桥接患者肥厚性心肌病

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The etiology of chest pain in hypertrophic cardiomyopathy (HC) is diverse and includes coronary artery disease (CAD) as well as HC-specific causes. Myocardial bridging (MB) has been associated with HC, chest pain, and accelerated atherosclerosis. We compared HC patients with age-, gender- and CAD pre-test probability-matched outpatients presenting with chest pain to investigate differences in the presence of MB and CAD using coronary computed tomography angiography (CCTA). We studied 84 HC patients who underwent CCTA and compared these with 168 matched controls (age 54 +/- 11 years, 70% men, pre-test probability 12% [5% to 32%]). MB, calcium score, plaque morphology and presence and extent of CAD were assessed for each patient. Linear mixed models were used to assess differences between cases and controls. MB was more often seen in HC patients (50% vs 25%, p <0.001). Calcium score and the presence of obstructive CAD were similar in both groups (9 [0 to 225] vs 4 [0 to 82] and 18% vs 19%; p = 0.22 and p = 0.82). In the HC group, MB was associated with pathogenic DNA variants (p = 0.04), but not with the presence of chest pain (74% vs 76%, p = 0.8), nor with worse outcome (log-rank p = 0.30). In conclusion, the prevalence and extent of CAD was equal among patients with and without HC, demonstrating that pre-test risk prediction using the CAD Consortium clinical risk score performs well in HC patients. MB was twice as prevalent in the HC group compared with matched controls, but was not associated with chest pain or decreased event-free survival in these patients. (C) 2020 The Author(s). Published by Elsevier Inc.
机译：肥厚性心肌病（HC）胸痛的病因是多种多样的，包括冠状动脉疾病（CAD）以及HC特异性原因。心肌桥接（MB）已与HC，胸痛和加速动脉粥样硬化有关。我们将HC患者与胸痛呈现出胸腔疼痛的年龄，性别和CAD预测概率匹配的门诊患者，以研究MB和CAD存在的差异，使用冠状动脉计算断层造影血管造影（CCTA）。我们研究了84名HC患者接受了CCTA的患者，并将这些患者与168名匹配对照（54岁+/- 11岁，70％的男性，预测试概率为12％[5％至32％]）。对每位患者评估CAD的MB，钙评分，斑块形态和存在和程度。线性混合模型用于评估病例和对照之间的差异。 MB更常见于HC患者（50％Vs 25％，P <0.001）。钙评分和阻塞性CAD的存在在两个基团（9 [0至225] Vs 4 [0至82]和18％Vs 19％; P = 0.22和P = 0.82）中。在HC组中，MB与致病DNA变体相关（P = 0.04），但没有胸部疼痛的存在（74％vs 76％，p = 0.8），也没有更差的结果（Log-Rank P = 0.30） 。总之，CAD的患病率和程度平等，患有和不含HC的患者，展示使用CAD联盟临床风险评分的试验预测在HC患者中表现良好。与匹配的对照相比，MB在HC组中普遍的普遍存在，但与胸痛无关或在这些患者中无胸痛的生存率无关。 （c）2020提交人。 elsevier公司发布

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