【摘要】 目的:探讨心尖肥厚型心肌病(AHCM)的临床表现、心电图特点、冠状动脉造影(CAG)结果和长期预后情况。方法:对53例经超声心动图确诊的AHCM患者,进行病史回顾、体格检查、心电图和CAG检查,并通过电话和门诊随访,了解心血管事件发生情况。结果:AHCM患者病史不典型,但心电图有特征性变化,表现为胸前导联巨大倒置T波,尤其以V4导联显著,伴有ST段下移,常被误诊为冠心病。30例行CAG者中28例示左冠状动脉明显增粗;3例发现器质性狭窄,并成功置入支架;7例发现心肌桥,均位于左前降支。经0·4~7·5年的随访,仅1例死于癌症。结论:AHCM有比较典型的心电图表现,左冠状动脉内径增粗,常并发肌桥和冠心病,远期预后较好。更多还原

【Abstract】 Objective:To explore the clinical manifestations, ECG characteristics,coronary angiography results and long-term prognosis of apical hypertrophic cardiomyopthy （AHCM）. Method:Fifty-three patients with AHCM ,confirmed by ultrasound cardiography, were received history review, physical examinations, ECG tests, and / or coronary angiography. Long-term follow-up was conducted by telephone or at outpatients’ room to ascertain the incidence of cardiovascular events. Result:The history of AHCM was not typical, but its ECG had characteristic changes, which showed great inverted T wave with ST segment depression at precordial leads, especially at V₄ lead. It was usually misdiagnosed as coronary heart disease, especially non-Q wave myocardial infarction. Among 30 patients undergoing coronary angiography, 28 patients showed large left coronary arteries, while 3 patients had significant stenotic lesion and then received successful stenting. Myocardial bridge was found in 7 patients. During the follow-up period of 0.4-7.5 years, only 1 patients died of cancer. Conclusion:AHCM has typical ECG changes with large left coronary arteries and good long-term prognosis, usually coexisting with myocardial bridges and coronary heart disease.更多还原