| Objective: To explore the clinical feature and diagnosis and treatment of adult HCM patients.Methods:The electronic medical record system was consulted to collect HCM patients hospitalized in our hospital from January 2014 to October 2019,and the clinical data of HCM patients were analyzed retrospectively.Results: 128 patients with HCM were collected,the common comorbidities of HCM patients include coronary heart disease,hypertension,diabetes,heart failure,atrial fibrillation,ischemic stroke and so on.Most symptoms of HCM patients are chest tightness / pain,dizziness,dyspnea,palpitation,syncope,ect.In the treatment plan,the utilization rate of β-blockers is the highest,followed by CCB,ACEI / ARB,diuretics,dual-chamber pacing / ICD implantation,and a few patients received septal alcohol ablation.Most HCM patients have good clinical prognosis,while a few patients suffer adverse clinical events such as sudden death during hospitalization.The incidence rate of palpitation symptoms in female HCM patients was higher than that in males(36.21% vs 20%,p=0.041)and heart failure(39.66% vs 22.86%,p=0.04)incidence was also significantly higher than that in male patients.Male HCM patients use diuretics more frequently than female patients(80.00% vs 51.72%,P = 0.001).The incidence of outflow tract obstruction in female patients was higher than that in male patients(41.38% vs 20.00%,P = 0.008),and the incidence of right atrial enlargement in male patients(25.71% vs 6.9%,P = 0.005)was higher than that in female patients.There is no significant difference in clinical features between HOCM and HNCM.The age of HCM patients with AF(66.73 ± 13.20 vs 59.72 ± 14.87,P = 0.043)is higher than that of patients without AF,syncope(13.64% vs 2.83,P = 0.029)and palpitation(72.73% vs 17.92,P < 0.001)were more severe than those of patients without AF.The incidence rate of coronary heart disease in HCM patients with AF(45.46% vs 22.64%,P = 0.027)was also significantly higher than that of patients without AF.The left atrial anteroposterior diameter(45.86 ± 6.88 vs 38.18 ± 6.79,P < 0.001),pulmonary artery diameter(24.32 ± 4.15 vs 22.36 ± 2.54,P = 0.043)and right atrial transverse diameter(37.50 ± 5.99 vs 34.47 ± 4.95,P = 0.013)of HCM patients with AF were significantly higher than those of patients without AF.The results of logistic regression analysis showed that the incidence of AF in HCM patients was associated with coronary heart disease(or(95% Cl): 3.94(1.23,12.69),P = 0.021] and left atrial size(or(95% Cl): 1.14(1.04,1.25),P = 0.005).Conclusion:In clinical practice,most of HCM patients have not received genetic counseling in time,and there are some differences between the medication plan and clinical guidelines.The incidence of symptoms in female patients with HCM is higher than that in male patients,and the long-term prognosis may be worse than that in male patients.Compared with HCM without AF,HCM patients complicated with AF had a higher proportion of symptoms and a more obvious degree of myocardial remodeling.HCM is a heterogeneous disease with complex manifestations,which varies greatly from patient to patient.Clinicians should accurately diagnose HCM and formulate precise treatment plans according to the principle of individualized treatment. |
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