| Sudden death in hypertrophic and dilated cardiomyopathy. | |
| | |
MedLine Citation:
|
PMID: 2632825 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
|
The long-term prognosis for 314 patients with hypertrophic cardiomyopathy (HCM) and 82 with dilated cardiomyopathy (DCM) was investigated in an attempt to elucidate clinical variables predicting sudden death (SD). In the patients with HCM, 68% of cardiac deaths occurred suddenly and unexpectedly. Variables associated with an increased risk to SD were young age (less than 30 years), reduced fractional shortening (less than 35%) and elevated left ventricular end-diastolic pressure (greater than or equal to 20 mmHg). Eight of the 10 patients who died suddenly during or immediately after strenuous exercise were less than 30 years old, and the collapse tended to be associated with exercise-induced ST-depression. In contrast, SD occurring during mild activities, resting or sleep was mainly observed in those aged 30 years or more. Ventricular tachycardia was observed on electrocardiographic monitoring in 24% of those 30 years or more, while it was rare in those under 30 years (5%). On the other hand, no SD was found in patients with apical hypertrophy nor in those 50 years or more. These observations suggest that HCM patients at a young age, with impaired left ventricular systolic and diastolic function, have an increased risk to SD. Since exercise-induced myocardial ischemia rather than ventricular arrhythmias appears to be the more likely mechanism for SD for those under 30 years old, restriction of strenuous exercise should be strongly advised for these patients. For those aged from 30 to 50 years, ventricular tachycardia should be controlled by antiarrhythmic agents for the prevention of SD. In patients with DCM, 24% of all cardiac deaths were attributed to SD. Although no variables reliably predicted SD, it was of note that only one patient out of 26 with SV1 + RV5 greater than or equal to 35 mm died suddenly. Whereas ventricular arrhythmias are known to be a contributing cause for SD, the prognostic significance of ventricular tachycardia on electrocardiographic monitoring in predicting SD has not yet been established. In addition, antiarrhythmic agents often precipitate hemodynamic deterioration. It therefore appears that use of antiarrhythmic agents is not a therapy of first choice and that primary treatment should be focused upon improvement in ventricular function in order to prevent SD in patients with DCM. |
| | |
Authors:
|
Y Koga; M Ogata; K Kihara; K Tsubaki; H Toshima |
Related Documents
:
|
3160865 - Effects of strenuous exercise on the quantitative morphology of left ventricular myocar... 2441995 - Evaluation of the efficacy and tolerance of the antiarrhythmic agent transcainide (r 54... 21459255 - Improving diet and exercise in pregnancy with video doctor counseling: a randomized trial. 18242375 - Relationship between testicular volume and varicocele in patients with infertility. 2623105 - Character structure and performance on the mmpi. 468655 - Human pulmonary resistance: effect of frequency and gas physical properties. |
Publication Detail:
|
Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
|
Title: Japanese circulation journal Volume: 53 ISSN: 0047-1828 ISO Abbreviation: Jpn. Circ. J. Publication Date: 1989 Dec |
Date Detail:
|
Created Date: 1990-05-18 Completed Date: 1990-05-18 Revised Date: 2008-11-21 |
Medline Journal Info:
|
Nlm Unique ID: 7806868 Medline TA: Jpn Circ J Country: JAPAN |
Other Details:
|
Languages: eng Pagination: 1546-56 Citation Subset: IM |
Affiliation:
|
Third Department of Medicine, Kurume University School of Medicine, Japan. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
Adult Age Factors Blood Pressure Cardiomyopathy, Dilated / mortality*, physiopathology Cardiomyopathy, Hypertrophic / mortality*, physiopathology Death, Sudden / epidemiology, etiology* Female Follow-Up Studies Heart Ventricles / physiopathology Humans Male Middle Aged Myocardial Contraction Physical Exertion Prognosis Risk Factors Survival Rate Tachycardia / mortality |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Clinical characteristics of sudden cardiac death in patients with vasospastic angina.
Next Document: Long-term prognostic assessment of ventricular tachycardia with respect to sudden death in patients ...