| Objective: To summarize the clinical characteristics and therapies of 84 patiengts with hypertrophic cardiomyopathy(HCM).Methods:Collected in January 2008- December 2013 in the first affiliated hospital of anhui medical university clinical data of 84 patients with hypertrophic cardiomyopathy,and were retrospectively analyzed.Result:Among the 84 patients(i.e.,male = 40,female = 44) with hypertrophic cardiomyopathy,41 cases(48.8%) were obstructive cardiomyopathy patients and 43cases(51.2%) patients were without obstructive cardiomyopathy.The age of diagnosis was 21 to 80 years old and arveage age was(51.5±14.5)years old.The age of onset in16 to 79 years old and arveage age was(48.0±15.4)years old.The average age of onset for female patients was(50.8 ± 14.8) years,and the average age of onset for male patients was(44.1 ± 12.8) years old.Gender age was compared and the difference was statistically significant(P <0.05).5 cases(6.0%) patients age was less than 18 years old,13 cases(15.5%) were greater than 65-year-old patients and there were 59 patients(78.6%) at 18-65 years old.All patients had clinical symptoms.Common clinical symptoms mainly included chest condition(86.9%), palpitations(53.6%), chest pain(47.6%), dyspnea(35.7%), dizziness and black Meng(27.38%), a precursor to syncope or syncope(17.9%).41 cases(48.8%) were hypertrophic obstructive cardiomyopathy(HOCM) patients and 43 cases(51.2%) patients were with hypertrophic nonobstructive cardiomyopathy(HNCM).Comparing HOCM and HNCM, the former is more than the latter female patients(P<0.05), but the two groups in age, is no significant difference in the age and occurrence of clinical symptoms(P> 0.05).46 cases of HOCM patients and 9 cases of HNCM patients can be smelled systolic murmur in the3,4 left border of sternum or apex.The difference was statistically significant(P <0.05)while comparing the two groups.NYHA functional class(NYHA classification):there were 69 patients(82.1%)with I-II class and 15 patients(17.9%)were with III-IV class.Merger disease situation:Among the patients there were 21 hypertension, which merged with cerebral hemorrhage, 1 cerebral infarction, 3 diabetes, 3 coronary heart disease, 1 hypothyroidism;1 cerebral infarction; 1 myocardial infarction; 1 infection endocarditis and mitral valve chordae rupture; 1 rheumatic heart disease and mitral valve prolapse; 4 obstructive pulmonary disease; 2 consolidated nephritis.Atrial arrhythmia and block were the most common arrhythmia.ECG performance:95.2% of the patients with hypertrophic cardiomyopathy ecg is abnormal and the most common abnormalities was left ventricular hypertrophy and(or)ST-T change(n = 76,90.5%).Echocardiographic performance:84 patients showed that the majority patients of echocardiographic performance was left ventricular wall and septal thickening,including four cases with apical thickening.41 patients showed outflow obstruction.The pressure ranges 30-124 mm Hg with average pressure(64.5 ± 29.6) mm Hg. 33 patients of HOCM patients had "SAM signs",while the HNCM patient had no this signs.Patients with HOCM and HNCM compared to both the left atrial size is no significant difference, but the former left ventricular size was significantly smaller than the latter(P <0.05), and interventricular septum thickness is larger than the latter(P<0.05). Associated with atrial fibrillation in patients with left atrial diameter was(51.5± 8.4) mm, greater than the non-AF patients with left atrial diameter(43.0 ± 6.7)mm(P <0.05).Treatment:Among the 84 patients,80 patients were treated with beta blockers and(or)two hydrogen pyridine class calcium ion antagonist therapy, 11 patients were treated with pacemaker placement, 22 patients received percutaneous transluminal septal myocardial ablation(PTSMA), 2 cases of patients were with surgery.Outcome:In 1 case death, the cause of death were malignant arrhythmia. Hospital patients symptoms were all alleviated.Conclusion:The clinical manifestations of Hypertrophic cardiomyopathy patients were not typical, most patient were treated with drugs and had a good prognosis. |
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