Аннотация
Пациенты с гипертрофической кардиомиопатией и экстремальной толщиной миокарда левого желудочка относятся к группе больных с прогрессирующим клиническим течением и высоким риском неблагоприятного исхода, включая сердечную недостаточность и внезапную сердечную смерть. Вопрос о том, является ли имплантация кардиовертера-дефибриллятора и миэктомия
эффективными методами профилактики внезапной сердечной смерти и лечения рефрактерной сердечной недостаточности у таких пациентов, не решен. Современные достижения в лечении гипертрофической кардиомиопатии оказались эффективными у многих пациентов, обеспечив
благоприятные отдаленные результаты. Однако могут ли они быть настолько же эффективными у больных с массивной гипертрофией левого желудочка? Обзор отражает взгляд на проблему экстремальных показателей толщины миокарда левого желудочка при гипертрофической кардиомиопатии.
Литература
- Bois J.P., Geske J., Ommen S., Pellikka P. Measure of maximal left ventricular wall thickness in hypertrophic cardiomyopathy differs when comparing magnetic resonance imaging and transthoracic echocardiography. J. Am. Coll. Cardiol. 2015; 65 (10, suppl.): А983. DOI: 10.1016/S0735-1097(15)60983-4
- Briasoulis A., Mallikethi-Reddy S., Palla M., Alesh I., Afonso L. Myocardial fibrosis on cardiac magnetic resonance and cardiac outcomes in hypertrophic cardiomyopathy: A meta-analysis. Heart. 2015; 101: 1406–11. DOI: 10.1136/heartjnl-2015-307682
- Rowin E.J., Maron B.J., Romashko M., Wang W., Rastegar H., Link M.S., Maron M.S. Impact of effective management strategies on patients with the most extreme phenotypic expression of hypertrophic cardiomyopathy. Am. J. Cardiol. 2019; 124 (1): 113–21. DOI: 10.1016/j.amjcard.2019.04.002
- Maron B.J. Clinical course and management of hypertrophic cardiomyopathy. N. Engl. J. Med. 2018; 379 (7): 655–68. DOI: 10.1056/nejmra1710575
- Maron B.J., Rowin E.J., Udelson J.E., Maron M.S. Clinical spectrum and management of heart failure in hypertrophic cardiomyopathy. JACC: Heart Fail. 2018; 6 (5): 353–63. DOI: 10.1016/j.jchf.2017.09.011
- Зарудский А.А., Кухарчук А.Е., Кретова А.А. Изучение феномена обструкции выносящего тракта левого желудочка в реальной клинической практике. Современные проблемы науки и образования. 2019; 2: 137. DOI: 10.17513/spno.28697
- Yang H., Carasso S., Woo A., Jamorski M., Nikonova A., Wigle E.D. et al. Hypertrophy pattern and regional myocardial mechanics are related in septal and apical hypertrophic cardiomyopathy. J. Am. Soc. Echocardiogr. 2010; 23: 1081–9. DOI: 10.1016/j.echo.2010.06.006
- Bois J.P., Geske J.B., Foley T.A., Ommen S.R., Pellikka P.A. Comparison of maximal wall thickness in hypertrophic cardiomyopathy differs between magnetic resonance imaging and transthoracic echocardiography. Am. J. Cardiol. 2017; 119: 643–50. DOI: 10.1016/j.amjcard. 2016.11.010
- Maron B.J., Haas T.S., Ahluwalia A., Murphy C.J., Garberich R.F. Demographics and epidemiology of sudden deaths in young competitive athletes: from the United States National Registry. Am. J. Med. 2016; 129 (11): 1170–7. DOI: 10.1016/j.amjmed.2016.02.031
- Maron B.J., Piccininno M., Casey S.A., Bernabó P., Spirito P. Relation of extreme left ventricular hypertrophy to age in hypertrophic cardiomyopathy. Am. J. Cardiol. 2003; 91 (5): 626–8. DOI: 10.1016/s0002-9149 (02)03326-x
- Guo X., Fan C., Tian L., Liu Y., Wang H., Zhao S. et al. The clinical features, outcomes and genetic characteristics of hypertrophic cardiomyopathy patients with severe right ventricular hypertrophy. PLoS One. 2017; 12 (3): e0174118. DOI: 10.1371/journal.pone.0174118
- Hirapur I., Kolhari V.B., Agrawal N., Rajendran R. Significant biventricular obstruction in non-syndromic hypertrophic cardiomyopathy. BMJ Case Rep. 2014; 2014: bcr2014206271. DOI: 10.1136/bcr-2014-206271
- Frank S., Braunwald E. Idiopathic hypertrophic subaortic stenosis. Clinical analysis of 126 patients with emphasis on the natural history. Circulation. 1968; 37 (5): 759–88. DOI: 10.1161/01.cir.37.5.759
- Botti G., Tagliavini S., Bonatti V., Aurier E. Isolated hypertrophic obstructive cardiomyopathy of the right ventricle. G. Ital. Cardiol. 1979; 9 (2): 170–81.
- Kоber L., Thune J.J., Nielsen J.C., Haarbo J., Videbæ k L., Korup E. et al. Defibrillator implantation in patients with nonischemic systolic heart failure. N. Engl. J. Med. 2016; 375: 1221–30. DOI: 10.1056/nejmoa1608029
- Rowin E., Romashko M., Maron B.J., Rastegar H., Maron M. Massive lv hypertrophy in hypertrophic cardiomyopathy is a high-risk subgroup, but is associated with favorable outcome with contemporary treatments. J. Am. Coll. Cardiol. 2018; 71 (11, Suppl.): А665. DOI: 10.1016/S0735-1097(18)31206-3
- Кардиология: национальное руководство / под ред. Е.В. Шляхто. 2-е изд., перераб. и доп. М.: ГЭОТАРМедиа; 2019. http://www.rosmedlib.ru/book/ISBN 9785970448106.html [Cardiology: national leadership / ed. E.V. Shlyakhto. Moscow: GEOTAR-Media; 2019 (in Russ.). Available at: http://www.rosmedlib.ru/book/ISBN 9785970448106.html
- Клинические рекомендации Министерства здравоохранения Российской Федерации. Гипертрофическая кардиомиопатия, 2016. https://legalacts.ru/doc/klinicheskie-rekomendatsii-gipertroficheskajakardiomiopatija-utv-minzdravom-rossii/
- Chang S.M., Lakkis N.M., Franklin J., Spencer W.H. III, Nagueh S.F. Predictors of outcome after alcohol septal ablation therapy in patients with hypertrophic obstructive cardiomyopathy. Circulation. 2004; 109 (7): 824–7. DOI: 10.1161/01.CIR.0000117089.99918.5A
- Faber L. Percutaneous septal ablation in hypertrophic obstructive cardiomyopathy: from experiment to standard of care. Adv. Med. 2014; 2014: 464851. DOI: 10.1155/2014/464851
- Rowin E.J., Maron B.J., Kiernan M.S., Casey S.A., Feldman D.S., Hryniewicz K.M. et al. Advanced heart failure with preserved systolic function in nonobstructive hypertrophic cardiomyopathy: under-recognized subset of candidates for heart transplant. Circ. Heart Fail. 2014; 7 (6): 967–75. DOI: 10.1161/CIRCHEARTFAILURE. 114.001435
- Topilsky Y., Pereira N.L., Shah D.K., Boilson B., Schirger J.A., Kushwaha S.S. et al. Left ventricular assist device therapy in patients with restrictive and hypertrophic cardiomyopathy. Circ. Heart Fail. 2011; 4 (3): 266–75. DOI: 10.1161/CIRCHEARTFAILURE. 110.959288
- Elliott P.M., Anastasakis A., Borger M.A., Borggrefe M., Cecchi F., Charron Ph. et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur. Heart J. 2014; 35 (39): 2733–79. DOI: 10.1093/eurheartj/ehu284
- Coutu M., Perrault L.P., White M., Pelletier G.B., Racine N., Poirier N.C. et al. Cardiac transplantation for hypertrophic cardiomyopathy: a valid therapeutic option. J. Heart Lung. Transplant. 2004; 23 (4): 413–7. DOI: 10.1016/S1053-2498(03)00225-0
- American Thoracic Society, American College of Chest Physicians. ATS/ACCP Statement on cardiopulmonary exercise testing. Am. J. Respir. Crit. Care Med. 2003; 167: 211–77. DOI: 10.1164/rccm.167.2.211
- Dass S., Cochlin L.E., Suttie J.J., Holloway C.J., Rider O.J., Carden L. et al. Exacerbation of cardiac energetic impairment during exercise in hypertrophic cardiomyopathy: a potential mechanism for diastolic dysfunction. Eur. Heart J. 2015; 36: 1547–54. DOI: 10.1093/eurheartj/ehv120
- Masri A., Pierson L.M., Smedira N.G., Agarwal S., Lytle B.W., Naji P. et al. Predictors of longterm outcomes in patients with hypertrophic cardiomyopathy undergoing cardiopulmonary stress testing and echocardiography. Am. Heart J. 2015; 169: 684–92. DOI: 10.1016/j.ahj.2015.02.006
- Coats C.J., Rantell K., Bartnik A., Patel A., Mist B., McKenna W.J., Elliott P.M. Cardiopulmonary exercise testing and prognosis in hypertrophic cardiomyopathy. Circ. Heart Fail. 2015; 8: 1022–31. DOI: 10.1161/CIRCHEARTFAILURE.114.002248
- Finocchiaro G., Haddad F., Knowles J.W., Caleshu C., Pavlovic A., Homburger J. et al. Cardiopulmonary responses and prognosis in hypertrophic cardiomyopathy: a potential role for comprehensive noninvasive hemodynamic assessment. JACC Heart Fail. 2015; 3: 408–18. DOI: 10.1016/j.jchf.2014.11.011
- Magrì D., Re F., Limongelli G., Agostoni P., Zachara E., Correale M. et al. Heart failure progression in hypertrophic cardiomyopathy: possible insights from cardiopulmonary exercise testing. Circ. J. 2016; 80: 2204–11. DOI: 10.1253/circj.CJ-16-0432 31. Magrì D., Limongelli G., Re F., Agostoni P., Zachara E., Correale M. et al. Cardiopulmonary exercise test and sudden cardiac death risk in hypertrophic cardiomyopathy. Heart. 2016; 102: 602–9. DOI: 10.1136/heartjnl2015-308453 32. Torres M.F., Herez-Villa F. Heart transplantation in patients with hypertrophic cardiomyopathy. Glob. Cardiol. Sci. Pract. 2018; 3: 32. DOI: 10.21542/gcsp.2018.32 33. Biagini E., Spirito P., Leone O., Picchio F.M., Coccolo F., Ragni L. et al. Heart transplantation in hypertrophic cardiomyopathy. Am. J. Cardiol. 2008; 101 (3): 387–92. DOI: 10.1016/j.amjcard.2007.09.085
- Huang X.S., Chen L.W., Pan Y.C., Lin F., Wang Q.M., Huang Z.Y. et al. Outcome post orthotopic heart transplantation for patients with end-stage hypertrophic cardiomyopathy. Zhonghua Xin Xue Guan Bing Za Zhi. 2011; 39 (2): 114–7.
- Lee M.S., Zimmer R., Kobashigawa J. Long-term outcomes of orthotopic heart transplantation for hypertrophic cardiomyopathy. Transplant. Proc. 2014; 46 (5): 1502–5. DOI: 10.1016/j.transproceed. 2013.12.052 36. Maron M.S., Finley J.J., Bos J.M., Hauser T.H., Manning W.J., Haas T.S. et al. Prevalence, clinical significance, and natural history of left ventricular apical aneurysms in hypertrophic cardiomyopathy. Circulation. 2008; 118 (15): 1541–9. DOI: 10.1161/CIRCULATIONAHA. 108.781401
- Coutu M., Perrault L.P., White M., Pelletier G.B., Racine N., Poirier N.C. et al. Cardiac transplantation for hypertrophic cardiomyopathy: a valid therapeutic option. J. Heart Lung Transplant. 2004; 23 (4): 413–7. DOI: 10.1016/S1053-2498(03)00225-0
- Kato T.S., Takayama H., Yoshizawa S., Marboe C., Schulze P.C., Farr M. et al. Cardiac transplantation in patients with hypertrophic cardiomyopathy. Am. J. Cardiol. 2012; 110 (4): 568–74. DOI: 10.1016/ j.amjcard.2012.04.030
- Pasqualucci D., Fornaro A., Castelli G., Rossi A., Arretini A., Chiriatti C. et al. Clinical spectrum, therapeutic options, and outcome of advanced heart failure in hypertrophic cardiomyopathy. Circ. Heart Fail. 2015; 8 (6): 1014–21. DOI: 10.1161/CIRCHEARTFAILURE. 114.001843
Об авторах
- Бокерия Лео Антонович, академик РАН и РАМН, президент, ORCID
- Берсенева Марина Ивановна, канд. мед. наук, заведующая отделением хирургического лечения кардиомиопатий, ORCID
- Хугаева Алина Ахсарбековна, мл. науч. сотр., ORCID
