循環器ジャーナル68巻1号

2020年01月発行

特集 U40世代が描く心不全診療の現状と未来—基礎研究を識り，臨床を素心深考する Ⅰ．心筋症

—臨床編—肥大型心筋症：拡張相に至る患者の規定因子は？予後規定因子は他にどのようなものがありますか？

著者： 馬場裕一¹ 久保亨¹

所属機関： ¹高知大学医学部 老年病・循環器内科学

ページ範囲：P.20 - P.25

Point
・肥大型心筋症は，最も頻度の高い遺伝性心疾患にもかかわらず，未診断の症例が多い．
・肥大型心筋症は，lifelong diseaseとしてのフォローアップが重要である．
・一次予防としてのICD植込み適応，予後規定因子など未解決の問題が少なくない．

参考文献

1) 日本循環器学会，他；心筋症診療ガイドライン（2018年改訂版）．2019

2) Maron BJ:Clinical Course and Management of Hypertrophic Cardiomyopathy. N Engl J Med 379:655-668, 2018

3) Elliott PM, Anastasakis A, Borger MA, 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 35:2733-2779, 2014

4) Maron MS, Olivotto I, Zenovich AG, et al:Hypertrophic cardiomyopathy is predominantly a disease of left ventricular outflow tract obstruction. Circulation 114:2232-2239, 2006

5) Silbiger JJ:Abnormalities of the Mitral Apparatus in Hypertrophic Cardiomyopathy:Echocardiographic, Pathophysiologic, and Surgical Insights. J Am Soc Echocardiogr 29:622-639, 2016

6) Kubo T, Hirota T, Baba Y, et al:Patients' Characteristics and Clinical Course of Hypertrophic Cardiomyopathy in a Regional Japanese Cohort-Results From Kochi RYOMA Study. Circ J 82:824-830, 2018

7) Olivotto I, Cecchi F, Poggesi C, et al:Patterns of disease progression in hypertrophic cardiomyopathy:an individualized approach to clinical staging. Circ Heart Fail 5:535-546, 2012

8) Heitner SB, Jacoby D, Lester SJ, et al:Mavacamten Treatment for Obstructive Hypertrophic Cardiomyopathy:A Clinical Trial. Ann Intern Med 170:741-748, 2019

9) Hirota T, Kubo T, Baba, et al:Clinical Profile of Thromboembolic Events in Patients With Hypertrophic Cardiomyopathy in a Regional Japanese Cohort-Results From Kochi RYOMA Study. Circ J 83:1747-1754, 2019

10) O' Mahony C, Jichi F, Ommen SR, et al:International External Validation Study of the 2014 European Society of Cardiology Guidelines on Sudden Cardiac Death Prevention in Hypertrophic Cardiomyopathy（EVIDENCE-HCM）. Circulation 137:1015-1023, 2018

11) O' Hanlon R, Grasso A, Roughton M, et al:Prognostic significance of myocardial fibrosis in hypertrophic cardiomyopathy. J Am Coll Cardiol 56:867-874, 2010

12) Kubo T, Kitaoka H, Yamanaka S, et al:Significance of high-sensitivity cardiac troponin T in hypertrophic cardiomyopathy. J Am Coll Cardiol 62:1252-1259, 2013

13) Guttmann OP, Pavlou M, O'Mahony C, et al:Prediction of thrombo-embolic risk in patients with hypertrophic cardiomyopathy（HCM Risk-CVA）. Eur J Heart Fail 17:837-845, 2015

14) Biagini E, Coccolo F, Ferlito M, et al:Dilated-hypokinetic evolution of hypertrophic cardiomyopathy:prevalence, incidence, risk factors, and prognostic implications in pediatric and adult patients. J Am Coll Cardiol 46:1543-1550, 2005