高危肥厚型心肌病患者的治疗策略

肥厚型心肌病是以不能解释的左心室肥大为特征、具有常染色体显性遗传特性的心肌疾病。梗阻性肥厚型心肌病患者因左室流出道存在梗阻，故症状明显，且更易出现恶性心律失常或心脏性猝死等严重事件，且尚无理想的治疗措施，目前以药物治疗、室间隔心肌酒精消融术、外科手术为主。现就心率慢而不能耐受药物治疗、具有心脏性猝死家族史且伴有晕厥、恶性心律失常的高危肥厚型心肌病患者的治疗做一综述。

Therapeutic Strategies in High-risk Patients with Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy （HCM） is an intrinsic myocardial disorder characterized by unexplained left ventricular hy pertrophy that occurs in the absence of pressure overload or storage/infiltrative disease. It is also a genetic disease with autosomal-dominant inheritance. HCM with dynamic obstruction of left ventricular outflow tract is more likely to occur malignancy arrhythmia or sudden cardiac death, and there are not ideal therapies for it so far. Now the therapy mainly includes drug, alcohol septal ablation and surgical intervention. This article reviews the current treatments for high-risk patients with HCM who suffer from malignancy ventricular arrhythmia, can＇ t tolerate drug therapy and have either a history of syncope or a family history of sudden cardiac death.