ISSN 1671-5411 CN 11-5329/R
Min GU, Han JIN, Wei HUA, Xiao-Han FAN, Hong-Xia NIU, Tao TIAN, Li-Gang DING, Jing WANG, Cong XUE, Shu ZHANG. Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy. J Geriatr Cardiol 2017; 14(4): 238-244. doi: 10.11909/j.issn.1671-5411.2017.04.002
Citation: Min GU, Han JIN, Wei HUA, Xiao-Han FAN, Hong-Xia NIU, Tao TIAN, Li-Gang DING, Jing WANG, Cong XUE, Shu ZHANG. Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy. J Geriatr Cardiol 2017; 14(4): 238-244. doi: 10.11909/j.issn.1671-5411.2017.04.002

Clinical outcome of cardiac resynchronization therapy in dilated-phase hypertrophic cardiomyopathy

doi: 10.11909/j.issn.1671-5411.2017.04.002
  • Received Date: 2017-01-20
  • Rev Recd Date: 2017-03-12
  • Publish Date: 2017-04-28
  • Backgrounds Clinical trials have demonstrated that cardiac resynchronization therapy (CRT) is effective in patients with “non-is?chemic cardiomyopathy”. However, patients with dilated-phase hypertrophic cardiomyopathy (DHCM) have been generally excluded from such trials. We aimed to compare the clinical outcome of CRT in patients with DHCM, idiopathic dilated cardiomyopathy (IDCM), or ischemic cardiomyopathy (ICM). Methods A total of 312 consecutive patients (DHCM: n = 16; IDCM: n = 231; ICM: n = 65) undergoing CRT in Fuwai hospital were studied respectively. Response to CRT was defined as reduction in left ventricular end-systolic volume (LVESV) ? 15% at 6-month follow-up. Results Compared with DHCM, IDCM was associated with a lower total mortality (HR: 0.35, 95% CI: 0.13–0.90), cardiac mortality (HR: 0.29; 95% CI: 0.11–0.77), and total mortality or heart failure (HF) hospitalizations (HR: 0.34, 95% CI: 0.17–0.69), independent of known confounders. Compared with DHCM, the total mortality, cardiac mortality and total mortality or HF hospitalizations favored ICM but were not statistically significant (HR: 0.59, 95% CI: 0.22–1.61; HR: 0.59, 95% CI: 0.21–1.63; HR: 0.54, 95% CI: 0.26–1.15; respectively). Response rate to CRT was lower in the DHCM group than the other two groups although the differences didn’t reach statistical significance. Conclusions Compared with IDCM, DHCM was associated with a worse outcome after CRT. The clinical outcome of DHCM patients receiving CRT was similar to or even worse than that of ICM patients. These indicate that DHCM behaves very differently after CRT.
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      沈阳化工大学材料科学与工程学院 沈阳 110142

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