Clinical Feature Analysis for Heart Failure in 32 Hypertrophic Cardiomyopathy Patients Presented as Restrictive Cardiomyopathy / 中国循环杂志

ABSTRACT

Objective: To analyze the clinical features for heart failure (HF) in hypertrophic cardiomyopathy patients presented as restrictive cardiomyopathy. Methods: We retrospectively studied 32 hypertrophic cardiomyopathy combining HF patients with NYHA grade III-IV presented as restrictive cardiomyopathy and summarized their clinical features with the outcomes of in-hospital management. Results: Echocardiography found restrictive cardiomyopathy changes in all 32 severe hypertrophic cardiomyopathy combining HF patients as both atriums were enlarged and the size of left ventricle was normal; 84.4％ patients with normal LVEF (>50％) and 15.6％ with LVEF<50％; 37.5％ patients with enlarged right ventricle. HF history was from 10 days to 35 years at the mean of 8.3 years. 75％ patients appeared whole heart failure, the main symptoms were dyspnea, edema, some patients had syncope and angina. There were 8 patients with respiratory failure, 2 with cardiac shock, 13 with medium to large amount of pleural effusion and ascites; 90％ patients combining paroxysmal or persistentatrial fibrillation (AF), 8 patients received pacemaker implantation due to slow tachycardia. The in-hospital ventricular tachycardia or ventricular fibrillation occurred in 3 patients, 2 of them were successfully rescued by electrical cardio-version and received implantable cardioverter defibrillator(ICD), 1 died for failed cardio-pulmonary resuscitation; 6 patients had heart transplantation.Conclusion: Severe hypertrophic cardiomyopathy combining HF patients presented as restrictive cardiomyopathy were usually at the late stage in critical condition with various complications even they could have normal size of left ventricle and LVEF, some patients may need heart transplantation.