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Alcohol Septal Ablation for Obstructive Hypertrophic Cardiomyopathy: A Word of Endorsement.
酒精间隔消融治疗梗阻性肥厚型心肌病: 一个认可的词。
heart team patient selection septal reduction therapy sudden cardiac death treatment outcome
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摘要

Twenty years after the introduction of alcohol septal ablation (ASA) for the treatment of obstructive hypertrophic cardiomyopathy, the arrhythmogenicity of the ablation scar appears to be overemphasized. When systematically reviewing all studies comparing ASA with myectomy with long-term follow-up, (aborted) sudden cardiac death and mortality rates were found to be similarly low. The focus should instead shift toward lowering the rate of reinterventions and pacemaker implantations following ASA because, in this area, ASA still seems inferior to myectomy. Part of the reason for this difference is that ASA is limited by the route of the septal perforators, whereas myectomy is not. Improvement may be achieved by: 1) confining ASA to hypertrophic cardiomyopathy centers of excellence with high operator volumes; 2) improving patient selection using multidisciplinary heart teams; 3) use of (3-dimensional) myocardial contrast echocardiography for selecting the correct septal (sub)branch; and 4) use of appropriate amounts of alcohol for ASA.

译文

在引入酒精间隔消融 (ASA) 治疗梗阻性肥厚型心肌病 20 年后,消融疤痕的心律失常性似乎被过分强调。当系统回顾所有研究比较 ASA 和长期随访的心肌切除术时,(流产的) 心脏性猝死和死亡率也同样低。相反,焦点应该转向降低 ASA 后的再干预和起搏器植入率,因为在这一领域,ASA 似乎仍然不如心肌切除术。造成这种差异的部分原因是 ASA 受间隔穿支途径的限制,而肌切除术则不受限制。改善可以通过以下方式实现: 1) 将 ASA 限制在高操作者容量的肥厚型心肌病卓越中心; 2) 使用多学科心脏团队改善患者选择; 3) 使用 (三维) 心肌声学造影选择正确的间隔 (子) 分支; 以及 4) 使用适量的酒精用于 ASA。

obstructive hypertrophic cardiomyopathy

心血管 常染色体显性遗传疾病 疾病
概述  :  

肥厚型心肌病是编码心肌肌小节蛋白的基因发生变异所致的种常染色体显性遗传疾病。主要表现为向心性心肌肥厚,心室腔变小。冠状动脉管壁增厚、胶原增加,管腔变小。二尖瓣前叶瓣体宽大约25%的肥厚型心肌病存在左室流出道梗阻,即肥厚型梗阻性心肌病(obstructive hypertrophic cardiomyopathy)。临床表现1、症状:临床症状除和左室流出道狭窄程度有关外,还和心室舒张功能、心肌缺血、心律失常有关。常见的症状有胸闷、胸痛、气短、晕厥、眩晕等。严重时出现心力衰竭症状。少部

Hypertrophic [,haipə'trɔfik]

释    义   adj. 肥厚的;过度膨胀的

例    句   Objective: To evaluate the clinical significance of myocardial backscatter parameters of hypertrophic myocardium in the patients with hypertension. 目的:探讨高血压病患者心肌不同肥厚程度背向散射参数变化的临床意义。

 

Obstructive 英 [əbˈstrʌktɪv]  美 [əbˈstrʌktɪv]

释    义   adj. 阻碍的;妨碍的

n. 妨碍物;障碍物

短    语   obstructive jaundice 梗阻性黄疸;阻塞性黄疸

obstructive pulmonary emphysema 阻塞性肺气肿

同根词   adj. obstructionist 阻挠议事的;蓄意阻挠的

n. obstruction 障碍;阻碍;妨碍

例    句   Both he and his father had the classic symptoms of obstructive sleep apnea. 他和他的父亲都有典型的睡眠呼吸暂停障碍的症状。

 

Cardiomyopathy 英 [,kɑːdɪəʊmaɪ'ɒpəθɪ]  美 [,kɑrdɪomaɪ'ɑpəθi]

释    义   n. (尤指原发性的)心肌症,心肌病

短    语   hypertrophic cardiomyopathy 肥厚型心肌病;肥大型心肌病

ischemic cardiomyopathy 缺血性心肌病

例    句   Prevention of dilated cardiomyopathy appears to be possible through regular supplementation with these two amino acids. 因此,定期补充服用这两种氨基酸可能可以预防扩张型心肌病的发生。


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