HCM Risk-SCD评分单独及联合LVEF对中青年肥厚型心肌病患者长期预后的预测价值  

Predictive value of HCM Risk-SCD score and it combined with LVEF in long-term prognosis of young and middle-aged patients with hypertrophic cardiomyopathy

作　　者：程栋[1,2,3] 秦臻 于凤仪 高佳敏 王泽禹 路永政 徐彦彦 杨宇 孙钊威 汤毅 桑海强[1,2,3] 唐俊楠 CHENG Dong;QIN Zhen;YU Fengyi;GAO Jiamin;WANG Zeyu;LU Yongzheng;XU Yanyan;YANG Yu;SUN Zhaowei;TANG Yi;SANG Haiqiang;TANG Junnan(Department of Cardiology,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Henan Province′s Key Laboratory of Cardiac Injury and Repair,Zhengzhou 450052;Henan Cardiovascular Disease Clinical Medical Research Center,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院心血管内科,郑州450052 [2]河南省心脏损伤修复重点实验室,郑州450052 [3]河南省心血管疾病临床医学研究中心,郑州450052

出　　处：《郑州大学学报（医学版）》2023年第5期656-661,共6页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金面上项目(82170281);河南省自然科学基金优秀青年基金项目(202300410362);中国心血管健康联盟进阶基金项目(2021-CCA-ACCESS-125)。

摘　　要：目的:探讨HCM Risk-SCD评分及其联合左心室射血分数(LVEF)预测中青年肥厚型心肌病(HCM)长期预后的价值。方法:收集2014年1月至2022年6月共224例确诊为HCM的中青年患者临床资料。通过Cox回归确定患者发生心源性猝死(SCD)的危险因素,ROC曲线分析LVEF联合HCM Risk-SCD评分对SCD的预测价值。结果:随访期间共发生SCD 17例。在调整了BMI、血小板计数等混杂因素后,HCM Risk-SCD评分对于患者生存结局的评估仍具有统计学意义(HR=1.321,95%CI为1.155~1.510,P<0.001)。HCM Risk-SCD评分与LVEF联合后AUC(95%CI)可达0.901(0.878~0.924),而HCM Risk-SCD评分AUC(95%CI)为0.776(0.762~0.790),LVEF AUC(95%CI)为0.683(0.665~0.701),联合后对HCM患者发生SCD的预测价值上升(P<0.05)。结论:HCM Risk-SCD评分联合LVEF可预测中青年HCM患者发生SCD。Aim:To evaluate the predictive value of HCM Risk-SCD score and it combined with left ventricular ejection fraction(LVEF)in long-term prognosis of young and middle-aged patients with hypertrophic cardiomyopathy(HCM).Methods:A total of 224 young and middle-aged patients with HCM from January 2014 to June 2022 were enrolled in this study.Cox regression analysis and ROC curve were used to figure out risk factors of sudden cardiac death(SCD)in HCM patients and evaluate predictive value of HCM Risk-SCD score combined with LVEF for the prognosis of HCM patients.Results:A total of 17 cases of SCD occurred during the follow-up period.After adjusting BMI,blood platelet count and other confounding factors,HCM Risk-SCD score was a risk factor of SCD in patients with HCM(HR=1.321,95%CI was 1.155-1.510,P<0.001).The AUC(95%CI)of combined HCM Risk-SCD score and LVEF was 0.901(0.878-0.924),which was higher than that of separated HCM Risk-SCD score(AUC=0.776,95%CI was 0.762-0.790)and LVEF(AUC=0.683,95%CI was 0.665-0.701)(P<0.05).Conclusion:HCM Risk-SCD score combined with LVEF is of predictive value of SCD in young and middle-aged patients with HCM.

关 键 词：肥厚型心肌病 HCM Risk-SCD评分 左心室射血分数 中青年 心源性猝死 长期预后 

分 类 号：R541.4[医药卫生—心血管疾病]