| 摘要: |
| ［摘要］ 目的 分析经皮心内膜室间隔射频消融术（PESA）治疗肥厚型梗阻性心肌病(HOCM)的临床效果。方法 回顾性分析2020年9月至2022年6月于青岛大学附属烟台毓璜顶医院心血管内科接受PESA治疗的11例HOCM患者的临床资料。比较患者术前及术后1～3 d、1～3个月及6～9个月的超声心动图结果、堪萨斯城心肌病患者生存质量表（KCCQ）评分、心源性猝死指数（SCDI）、纽约心脏病协会(NYHA)心功能分级，记录并发症发生情况。结果 11例患者中男2例，女9例，平均年龄（64.00±10.20）岁。与术前相比，患者术后左心室流出道压差（LVOTPG）水平显著下降（P<0.05），而室间隔厚度（IVST）、左心室质量指数（LVMI）、左房内径（LAD）、左室后壁厚度（LVPW）、左室舒张末期内径（LVEDD）、左室射血分数（LVEF）、舒张早期二尖瓣血流速度（E）、舒张早期二尖瓣环处心肌运动速度（e′）及E/e′比值变化不显著（P>0.05）。患者术后躯体受限得分、自我评价得分、症状得分、自我认识得分、心理得分、社会功能得分、临床得分、总得分均较术前显著上升（P<0.05）。与术前相比，患者术后NYHA分级显著改善（P<0.05），SCDI水平显著下降（P<0.05）。术后随访出现完全性左束支传导阻滞1例、房性期前收缩1例。结论 PESA可显著改善HOCM患者临床症状，提升生活质量，且并发症较少，为HOCM治疗提供了一种安全有效的选择。 |
| 关键词: 经皮心内膜室间隔射频消融术 肥厚型梗阻性心肌病 临床疗效 |
| DOI：10.3969/j.issn.1674-3806.2025.03.07 |
| 分类号:R 542.2 |
| 基金项目:国家自然科学基金项目（编号：8220503） |
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| Analysis on the clinical efficacy of percutaneous endocardial septal radiofrequency ablation in treatment of hypertrophic obstructive cardiomyopathy |
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LUAN Mingwei1, LIU Yugang2, WANG Hua2, WANG Guangqiang2, REN Mengmeng2, ZHONG Lin2
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1.School of Clinical Medicine, Shandong Second Medical University, Weifang 261053, China; 2.Department of Cardiovascular Medicine, Yantai Yuhuangding Hospital Affiliated to Qingdao University, Yantai 264001, China
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| Abstract: |
| ［Abstract］ Objective To analyze the clinical efficacy of percutaneous endocardial septal radiofrequency ablation(PESA) in treatment of hypertrophic obstructive cardiomyopathy(HOCM). Methods The clinical data of 11 patients with HOCM who received PESA treatment in Department of Cardiovascular Medicine, Yantai Yuhuangding Hospital Affiliated to Qingdao University from September 2020 to June 2022 were retrospectively analyzed. The results of echocardiography, Kansas City Cardiomyopathy Questionnaire(KCCQ) scores, sudden cardiac death index(SCDI), New York Heart Association(NYHA) cardiac function grades in the patients were compared before surgery and 1 to 3 days after surgery, 1 to 3 months after surgery and 6 to 9 months after surgery and the occurrence of complications was recorded. Results Among the 11 patients, there were 2 males and 9 females with an average age of (64.00±10.20)years. Compared with those before surgery, the patients′ left ventricular outflow tract pressure gradient(LVOTPG) levels were significantly decreased(P<0.05), while their interventricular septum thickness(IVST), left ventricular mass index(LVMI), left atrial diameter(LAD), left ventricular posterior wall thickness(LVPW), left ventricular end-diastolic diameter(LVEDD), left ventricular ejection fraction(LVEF), early diastolic mitral inflow velocity(E), early diastolic mitral annular velocity(e′), and E/e′ ratio did not change significantly after surgery(P>0.05). Compared with those before surgery, the patients′ physical limitation scores, self-evaluation scores, symptom scores, self-awareness scores, psychological scores, social function scores, clinical scores and total scores were significantly increased after surgery(P<0.05). Compared with those before surgery, the patients′ NYHA cardiac function grades were significantly improved(P<0.05), and their SCDI levels were significantly decreased(P<0.05). One case of complete left bundle branch block and 1 case of atrial premature contraction were observed during postoperative follow-up. Conclusion PESA can significantly improve HOCM patients′ clinical symptoms and enhance their quality of life with fewer complications, providing a safe and effective option for HOCM treatment. |
| Key words: Percutaneous endocardial septal radiofrequency ablation(PESA) Hypertrophic obstructive cardiomyopathy(HOCM) Clinical efficacy |
