Clinical Analysis Of Atrial Fibrillation In Patients With Hypertrophic Cardiomyopathy

Part1 Clinical features and risk factors of hypertrophic cardiomyopathy with atrial fibrillationObjective:This article aims to explore the clinical features and the risk factors of atrial fibrillation in patients with hypertrophic cardiomyopathy.Methods:A total of 180 patients were enrolled in our hospital from January 2012 to December 2019.According to the occurrence of atrial fibrillation divided into non-atrial fibrillation group(141 patients)and atrial fibrillation group(39 patients),the clinical data were recorded for analysis.Multivariate logistic regression was used to analyze the risk factors of atrial fibrillation in hypertrophic cardiomyopathy patients.Result:1.Compared between the two groups found that age(66.56±10.85 years vs 55.87±15.24 years),New York Heart Association cardiac function classification(2.79±0.89 vs 1.99±0.82),cardiac troponin T(0.41 ± 1.37ng/ml vs 0.04±0.08ng/ml),N-terminal pro-brain natriuretic peptide(2433.82±2347.17pg/ml vs 1421.02±2062.80pg/ml),left atrium diameter(44.59±5.02mm vs 39.02±4.50 mm),left ventricular ejection fraction(64.10 ± 10.49%vs 67.72±7.50%)and pulmonary artery diameter(26.95±4.39mm vs 25.24±2.51mm)were statistically significant(P<0.05).2.Multivariate logistic regression analysis indicated that the hypertrophic cardiomyopathy patients with atrial fibrillation were related to age(OR=1.048,P=0.022),New York Heart Association cardiac function classification(OR=2.204,P=0.018),left atrial diameter(OR=1.260,P=0.001).3.The risk factors for atrial fibrillation with hypertrophic cardiomyopathy in men are New York Heart Association cardiac function classification(OR=2.479,P=0.031)and left atrial diameter(OR=1.304,P=0.002),and the risk factors for atrial fibrillation in women are left atrial diameter(OR=1.210,P=0.007).The risk factors for atrial fibrillation in non-obstructive hypertrophic cardiomyopathy are New York Heart Association cardiac function classification(OR=3.176,P=0.009),left atrial diameter(OR=1.298,P=0.002),and the risk factor for atrial fibrillation in obstructive hypertrophic cardiomyopathy is left atrial diameter(OR=1.176,P=0.047).Conclusion:1.Hypertrophic cardiomyopathy with atrial fibrillation is related to age,New York Heart Association cardiac function classification,cardiac troponin T,N-terminal pro-brain natriuretic peptide,left atrial diameter,left ventricular ejection fraction and pulmonary artery diameter.2.Old age,poor New York Heart Association cardiac function classificational,and left atrial diameter increase are independent risk factors for hypertrophic cardiomyopathy with atrial fibrillation.3.There are differences in the analysis of independent risk factors for different genders and different types of hypertrophic cardiomyopathy with atrial fibrillation.Part2 Therapy of hypertrophic cardiomyopathy with different atrial fibrillation typesObjective:By reviewing the therapy of hypertrophic cardiomyopathy patients with atrial fibrillation in our hospital,expect to better standardize clinical practice and provide a theoretical basis for clinical management.Methods:A total of 39 patients were enrolled in our hospital from January 2012 to December 2019.They were divided into two groups:paroxysmal atrial fibrillation group(24 patients)and persistent atrial fibrillation group(15 patients),record the patient’s clinical treatment,Univariate analysis was used to analyze the difference in clinical treatment between the two groups.Result:A total of 39 patients were recorded in our study.Compared between the two groups found that age(71.00±9.76 years vs 63.79±10.75 years),CHA2DS2-VASc score(3.20±0.82 vs 1.73±1.63)was higher than the paroxysmal atrial fibrillation group.The use of anticoagulation(16.7%vs 66.7%)and diuretics(53.3%vs 20.8%)in the persistent atrial fibrillation group was higher than that in the paroxysmal atrial fibrillation group,and the use of antiplatelet aggregation drugs was lower than that in the paroxysmal atrial fibrillation group(26.7%vs 62.5%).Conclusion:1.Compared with patients with paroxysmal atrial fibrillation,patients with persistent atrial fibrillation are older and have a higher CHA2DS2-VASc score.2.In two groups,basic drugs for hypertrophic cardiomyopathy such as β-blockers and calcium antagonists are used relatively standardly,but the use of anticoagulant drugs is insufficient.