A clinical prognostic study on patients with HCM combined with coronary heart disease in different hypertrophic areas
Hu Jingchao
Xu zuojuan
Chen Qizhi
Yin ping
Abstract：Objective To investigate the clinical characteristics and prognosis of hypertrophic cardiomyopathy(HCM)with coronary atherosclerotic heart disease(CHD)at different hypertrophic sites,as well as the prognostic factors.Method 77 patients with HCM complicated with coronary heart disease who were hospitalized in the Department of Cardiology,Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from January 2018 to June 2022 were collected as the observation group.Patients in the observation group were divided into three groups based on different locations of myocardial hypertrophy:interventricular septal hypertrophy,apical hypertrophy,and other types of hypertrophy.At the same time,63 patients with coronary heart disease without HCM who were hospitalized during the same period were selected as the control group.Record the general information,clinical symptoms,clinical examination data,and follow-up adverse cardiovascular events of all patients and conduct comparative analysis.Divide them into subgroups with poor prognosis and subgroups with good prognosis based on the occurrence of adverse cardiovascular events.Compare and analyze the data of the two subgroups,and use logistic multiple regression to analyze the prognostic factors.Results The incidence of syncope in the interventricular septum group was higher than that in the control group and apical group(P＜0.05),the systolic blood pressure in the interventricular septum group was higher than that in the control group(P＜0.05),the left ventricular ejection fraction in the interventricular septum group,apical group,and other groups was lower than that in the control group(P＜0.05),and the left ventricular ejection fraction in the apical group and other groups was higher than that in the apical group(P＜0.05),The proportion of patients without vascular stenosis in the apex group and control group was higher than that in the interventricular septum group(P＜0.05),and the proportion of patients with one vessel stenosis degree greater than 75％in the interventricular septum group was higher than that in the apex group and control group(P＜0.05).The incidence of adverse cardiovascular events in the interventricular septum group was 57.58％,significantly higher than 26.09％in the apex group,19.05％in the other groups,and 15.87％in the control group(P＜0.05).Comparing the subgroups with poor prognosis and good prognosis,statistical significance was found in terms of age,systolic blood pressure,hypercholesterolemia,left ventricular ejection fraction,cumulative number of coronary arteries,and degree of vascular stenosis(P＜0.05).Through multiple logistic regression analysis,it was found that age(P=0.023,OR=2.104),left ventricular ejection fraction(P=0.016,OR=0.903),degree of vascular stenosis(P=0.005,OR=3.273),and cumulative number of coronary arteries(P=0.024,OR=1.138)are prognostic factors for HCM combined with coronary heart disease.Conclusion Among patients with HCM combined with coronary heart disease in different hypertrophic sites,patients with interventricular septal hypertrophy have a higher incidence of syncope,severe vascular stenosis,and poor prognosis.Age,left ventricular ejection fraction,degree of vascular stenosis,and cumulative number of coronary arteries are influencing factors for the prognosis of HCM combined with coronary heart disease.Targeted treatment measures should be taken according to different hypertrophic sites to help improve the prognosis of patients.
Keywords：Hypertrophic cardiomyopathyCoronary atherosclerotic heart diseasePrognosisInfluence factor
Publication Date：2025-02-20
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：5( 232-236 )