Фибрилляция предсердий (ФП) – одно из основных нарушений ритма у пациентов с гипертрофической кардиомиопатией (ГКМП). В обзорной статье представлены данные об эпидемиологии, излагаются новейшие представления о факторах риска и патогенезе, в частности роли инсулинорезистентности в возникновении этого нарушения ритма при ГКМП. Отражены современные подходы к лечению данного нарушения ритма при ГКМП с учетом существующих международных рекомендаций.
Atrial fibrillation (AF) is a particularly important arrhythmia in hypertrophic cardiomyopathy (HCM). This article describes the epidemiology of AF within the HCM population and analyses risk factors for the development of AF. The possible relation between the development of atrial fibrillation (AF) and insulin resistance in patients with HCM is also discussed. Here, we also review the outcomes associated with AF in HCM population and pharmacologic treatment strategies in this patient group.
1. Authors/Task Force members, Elliott PM, Anastasakis A, Borger MA et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 2014; 35 (39): 2733–79. DOI: 10.1093/eurheartj/ehu284
2. Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol 2015; 65 (12): 1249–54. DOI: 10.1016/j.jacc.2015. 01.019
3. Maron BJ, Maron MS, Semsarian C. Genetics of hypertrophic cardiomyopathy after 20 years: clinical perspectives. J Am Coll Cardiol 2012; 60 (8): 705–15. DOI: 10.1016/j.jacc.2012.02. 068
4. Lopes LR, Zekavati A, Syrris P et al. Genetic complexity in hypertrophic cardiomyopathy revealed by high-throughput sequencing. J Med Genet 2013; 50 (4): 228–39. DOI: 10.1136/jmedgenet-2012-101270
5. Kassem HSh, Azer RS, Saber-Ayad M et al. Early results of sarcomeric gene screening from the Egyptian National BA-HCM Program. J Cardiovasc Translat Res 2013; 6 (1): 65–80. DOI: 10.1007/s12265-012-9425-0
6. Van Driest SL, Ommen SR, Tajik AJ et al. Yield of genetic testing in hypertrophic cardiomyopathy. Mayo Clinic Proceedings 2005; 80 (6): 739–44. DOI: 10.4065/80.6.739
7. Brito D, Miltenberger-Miltenyi G, Vale Pereira S et al. Sarcomeric hypertrophic cardiomyopathy: genetic profile in a Portuguese population. Rev Port Cardiol 2012; 31 (9): 577–87. DOI: 10.1016/j.repc.2011.12.020
8. Morita H, Rehm HL, Menesses A et al. Shared genetic causes of cardiac hypertrophy in children and adults. N Engl J Med 2008; 358 (18): 1899–908. DOI: 10.1056/NEJMoa075463
9. Alfares AA, Kelly MA, McDermott G et al. Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity. Genet Med 2015; 17 (11): 880–8. DOI: 10.1038/gim.2014.205.
10. Hodatsu A, Konno T, Hayashi K et al. Compound heterozygosity deteriorates phenotypes of hypertrophic cardiomyopathy with founder MYBPC3 mutation: evidence from patients and zebrafish models. Am J Physiol – Heart and Circulatory Physiology 2014; 307 (11): H1594–H1604. DOI: 10.1152/ajpheart.00637.2013
11. Girolami F, Ho CY, Semsarian C et al. Clinical features and outcome of hypertrophic cardiomyopathy associated with triple sarcomere protein gene mutations. J Am Coll Cardiol 2010; 55 (14): 1444–53. DOI: 10.1016/j.jacc.2009.11.062
12. Li L, Bainbridge MN, Tan Y et al. A potential oligogenic etiology of hypertrophic cardiomyopathy: a classic single-gene disorder. Circulation Res 2017; 120: 1084–90. DOI: 10.1161/CIRCRESAHA.116.310559
13. Cooper RM, Raphael CE, Liebregts M et al. New Developments in Hypertrophic Cardiomyopathy. Can J Cardiol 2017; 33 (10): 1254–65. DOI: 10.1016/j.cjca.2017.07.007
14. Marian AJ, Braunwald E. Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy. Circulation Res 2017; 121 (7): 749–70. DOI: 10.1161/CIRCRESAHA.117.311059
15. Eriksson MJ, Sonnenberg B, Woo A et al. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol 2002; 39 (4): 638–45. DOI: 10.1016/S0735-1097(01)01778-8
16. Binder J, Attenhofer Jost CH, Klarich KW et al. Apical hypertrophic cardiomyopathy: prevalence and correlates of apical outpouching. J Am Soc Echocardiogr 2011; 24 (7): 775–81. DOI: 10.1016/j.echo.2011.03.002
17. D’Amato R, Tomberli B, Castelli G et al. Prognostic value of N-terminal pro-brain natriuretic Peptide in outpatients with hypertrophic cardiomyopathy. Am J Cardiol 2013; 112 (8): 1190–6. DOI: 10.1016/j.amjcard.2013.06.018
18. Guttmann OP, Rahman MS, O'Mahony C et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart 2014; 100 (6): 465–72. DOI: 10.1136/heartjnl-2013-304276
19. Rowin EJ, Hausvater A, Link MS et al. Clinical Profile and Consequences of Atrial Fibrillation in Hypertrophic Cardiomyopathy. Circulation 2017. DOI: 10.1161/CIRCULATIONAHA.117.029267
20. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31 (19): 2369–29. DOI: 10.1093/eurheartj/ehq278
21. Lloyd-Jones DM, Wang TJ, Leip EP et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 2004; 110 (9): 1042–6. DOI: 10.1161/01.CIR. 0000140263.20897.42
22. Kirchhof P, Benussi S, Kotecha D et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37 (38): 2893–962. DOI: 10.1093/eurheartj/ehw210
23. Camm CF, Camm AJ. Atrial Fibrillation and Anticoagulation in Hypertrophic Cardiomyopathy. Arrhythm and Electrophysiol Rev 2017; 6 (2): 63–8. DOI: 10.15420/aer.2017.4.2
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26. Ogimoto A, Hamada M, Nakura J et al. Relation between angiotensin-converting enzyme II genotype and atrial fibrillation in Japanese patients with hypertrophic cardiomyopathy. J Hum Genet 2002; 47 (4): 184–9. DOI: 10.1007/s100380200021
27. Spirito P, Autore C, Formisano F et al. Risk of sudden death and outcome in patients with hypertrophic cardiomyopathy with benign presentation and without risk factors. Am J Cardiol 2014; 113 (9): 1550–5. DOI: 10.1016/j.amjcard.2014.01.435
28. Tani T, Tanabe K, Ono M et al. Left atrial volume and the risk of paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 2004; 17 (6): 644–8. DOI: 10.1016/j.echo.2004.02.010
29. Olivotto I, Cecchi F, Casey SA et al. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 2001; 104 (21): 2517–24. DOI: 10.1161/hc4601.097997
30. Losi MA, Betocchi S, Aversa M et al. Determinants of atrial fibrillation development in patients with hypertrophic cardiomyopathy. Am J Cardiol 2004; 94 (1): 895–900. DOI: 10.1016/j.amjcard.2004.06.024
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33. Autore C, Bernabo P, Barilla CS et al. The prognostic importance of left ventricular outflow obstruction in hypertrophic cardiomyopathy varies in relation to the severity of symptoms. J Am Coll Cardiol 2005; 45 (7): 1076–80. DOI: 10.1016/j.jacc.2004.12.067
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1. Authors/Task Force members, Elliott PM, Anastasakis A, Borger MA et al. 2014 ESC Guidelines on diagnosis and management of hypertrophic cardiomyopathy: the Task Force for the Diagnosis and Management of Hypertrophic Cardiomyopathy of the European Society of Cardiology (ESC). Eur Heart J 2014; 35 (39): 2733–79. DOI: 10.1093/eurheartj/ehu284
2. Semsarian C, Ingles J, Maron MS, Maron BJ. New perspectives on the prevalence of hypertrophic cardiomyopathy. J Am Coll Cardiol 2015; 65 (12): 1249–54. DOI: 10.1016/j.jacc.2015. 01.019
3. Maron BJ, Maron MS, Semsarian C. Genetics of hypertrophic cardiomyopathy after 20 years: clinical perspectives. J Am Coll Cardiol 2012; 60 (8): 705–15. DOI: 10.1016/j.jacc.2012.02. 068
4. Lopes LR, Zekavati A, Syrris P et al. Genetic complexity in hypertrophic cardiomyopathy revealed by high-throughput sequencing. J Med Genet 2013; 50 (4): 228–39. DOI: 10.1136/jmedgenet-2012-101270
5. Kassem HSh, Azer RS, Saber-Ayad M et al. Early results of sarcomeric gene screening from the Egyptian National BA-HCM Program. J Cardiovasc Translat Res 2013; 6 (1): 65–80. DOI: 10.1007/s12265-012-9425-0
6. Van Driest SL, Ommen SR, Tajik AJ et al. Yield of genetic testing in hypertrophic cardiomyopathy. Mayo Clinic Proceedings 2005; 80 (6): 739–44. DOI: 10.4065/80.6.739
7. Brito D, Miltenberger-Miltenyi G, Vale Pereira S et al. Sarcomeric hypertrophic cardiomyopathy: genetic profile in a Portuguese population. Rev Port Cardiol 2012; 31 (9): 577–87. DOI: 10.1016/j.repc.2011.12.020
8. Morita H, Rehm HL, Menesses A et al. Shared genetic causes of cardiac hypertrophy in children and adults. N Engl J Med 2008; 358 (18): 1899–908. DOI: 10.1056/NEJMoa075463
9. Alfares AA, Kelly MA, McDermott G et al. Results of clinical genetic testing of 2,912 probands with hypertrophic cardiomyopathy: expanded panels offer limited additional sensitivity. Genet Med 2015; 17 (11): 880–8. DOI: 10.1038/gim.2014.205.
10. Hodatsu A, Konno T, Hayashi K et al. Compound heterozygosity deteriorates phenotypes of hypertrophic cardiomyopathy with founder MYBPC3 mutation: evidence from patients and zebrafish models. Am J Physiol – Heart and Circulatory Physiology 2014; 307 (11): H1594–H1604. DOI: 10.1152/ajpheart.00637.2013
11. Girolami F, Ho CY, Semsarian C et al. Clinical features and outcome of hypertrophic cardiomyopathy associated with triple sarcomere protein gene mutations. J Am Coll Cardiol 2010; 55 (14): 1444–53. DOI: 10.1016/j.jacc.2009.11.062
12. Li L, Bainbridge MN, Tan Y et al. A potential oligogenic etiology of hypertrophic cardiomyopathy: a classic single-gene disorder. Circulation Res 2017; 120: 1084–90. DOI: 10.1161/CIRCRESAHA.116.310559
13. Cooper RM, Raphael CE, Liebregts M et al. New Developments in Hypertrophic Cardiomyopathy. Can J Cardiol 2017; 33 (10): 1254–65. DOI: 10.1016/j.cjca.2017.07.007
14. Marian AJ, Braunwald E. Hypertrophic Cardiomyopathy: Genetics, Pathogenesis, Clinical Manifestations, Diagnosis, and Therapy. Circulation Res 2017; 121 (7): 749–70. DOI: 10.1161/CIRCRESAHA.117.311059
15. Eriksson MJ, Sonnenberg B, Woo A et al. Long-term outcome in patients with apical hypertrophic cardiomyopathy. J Am Coll Cardiol 2002; 39 (4): 638–45. DOI: 10.1016/S0735-1097(01)01778-8
16. Binder J, Attenhofer Jost CH, Klarich KW et al. Apical hypertrophic cardiomyopathy: prevalence and correlates of apical outpouching. J Am Soc Echocardiogr 2011; 24 (7): 775–81. DOI: 10.1016/j.echo.2011.03.002
17. D’Amato R, Tomberli B, Castelli G et al. Prognostic value of N-terminal pro-brain natriuretic Peptide in outpatients with hypertrophic cardiomyopathy. Am J Cardiol 2013; 112 (8): 1190–6. DOI: 10.1016/j.amjcard.2013.06.018
18. Guttmann OP, Rahman MS, O'Mahony C et al. Atrial fibrillation and thromboembolism in patients with hypertrophic cardiomyopathy: systematic review. Heart 2014; 100 (6): 465–72. DOI: 10.1136/heartjnl-2013-304276
19. Rowin EJ, Hausvater A, Link MS et al. Clinical Profile and Consequences of Atrial Fibrillation in Hypertrophic Cardiomyopathy. Circulation 2017. DOI: 10.1161/CIRCULATIONAHA.117.029267
20. European Heart Rhythm Association; European Association for Cardio-Thoracic Surgery, Camm AJ, Kirchhof P, Lip GY et al. Guidelines for the management of atrial fibrillation: the Task Force for the Management of Atrial Fibrillation of the European Society of Cardiology (ESC). Eur Heart J 2010; 31 (19): 2369–29. DOI: 10.1093/eurheartj/ehq278
21. Lloyd-Jones DM, Wang TJ, Leip EP et al. Lifetime risk for development of atrial fibrillation: the Framingham Heart Study. Circulation 2004; 110 (9): 1042–6. DOI: 10.1161/01.CIR. 0000140263.20897.42
22. Kirchhof P, Benussi S, Kotecha D et al. 2016 ESC Guidelines for the management of atrial fibrillation developed in collaboration with EACTS. Eur Heart J 2016; 37 (38): 2893–962. DOI: 10.1093/eurheartj/ehw210
23. Camm CF, Camm AJ. Atrial Fibrillation and Anticoagulation in Hypertrophic Cardiomyopathy. Arrhythm and Electrophysiol Rev 2017; 6 (2): 63–8. DOI: 10.15420/aer.2017.4.2
24. Krylova N.S., Demkina A.E., Khashieva F.M. i dr. Fibrilliatsiia i trepetanie predserdii u bol'nykh s gipertroficheskoi kardiomiopatiei. Ros. kardiol. zhurn. 2015; 5: 64–70. DOI: 10.15829/1560-4071-2015-5-64-70. [in Russian]
25. Gruver EJ, Fatkin D, Dodds GA et al. Familial hypertrophic cardiomyopathy and atrial fibrillation caused by Arg663His beta-cardiac myosin heavy chain mutation. Am J Cardiol 1999; 83 (12A): 13H–18H. DOI: 10.1016/s0002-9149(99)00251-9
26. Ogimoto A, Hamada M, Nakura J et al. Relation between angiotensin-converting enzyme II genotype and atrial fibrillation in Japanese patients with hypertrophic cardiomyopathy. J Hum Genet 2002; 47 (4): 184–9. DOI: 10.1007/s100380200021
27. Spirito P, Autore C, Formisano F et al. Risk of sudden death and outcome in patients with hypertrophic cardiomyopathy with benign presentation and without risk factors. Am J Cardiol 2014; 113 (9): 1550–5. DOI: 10.1016/j.amjcard.2014.01.435
28. Tani T, Tanabe K, Ono M et al. Left atrial volume and the risk of paroxysmal atrial fibrillation in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 2004; 17 (6): 644–8. DOI: 10.1016/j.echo.2004.02.010
29. Olivotto I, Cecchi F, Casey SA et al. Impact of atrial fibrillation on the clinical course of hypertrophic cardiomyopathy. Circulation 2001; 104 (21): 2517–24. DOI: 10.1161/hc4601.097997
30. Losi MA, Betocchi S, Aversa M et al. Determinants of atrial fibrillation development in patients with hypertrophic cardiomyopathy. Am J Cardiol 2004; 94 (1): 895–900. DOI: 10.1016/j.amjcard.2004.06.024
31. Siontis KC, Geske JB, Ong K et al. Atrial fibrillation in hypertrophic cardiomyopathy: prevalence, clinical correlations, and mortality in a large high-risk population. J Am Heart Association 2014; 3 (3): e001002. DOI: 10.1161/JAHA.114.001002
32. Doesch C, Lossnitzer D, Rudic B et al. Right ventricular and right atrial involvement can predict atrial fibrillation in patients with hypertrophic cardiomyopathy? Int J Med Sci 2016; 13 (1): 1–7. DOI: 10.7150/ijms.13530
33. Autore C, Bernabo P, Barilla CS et al. The prognostic importance of left ventricular outflow obstruction in hypertrophic cardiomyopathy varies in relation to the severity of symptoms. J Am Coll Cardiol 2005; 45 (7): 1076–80. DOI: 10.1016/j.jacc.2004.12.067
34. Maron BJ, Olivotto I, Spirito P et al. Epidemiology of hypertrophic cardiomyopathy-related death: revisited in a large non-referral-based patient population. Circulation 2000; 102 (8): 858–64. DOI: 10.1161/01.CIR.102.8.858
35. Yang WI, Shim CY, Kim YJ et al. Left atrial volume index: a predictor of adverse outcome in patients with hypertrophic cardiomyopathy. J Am Soc Echocardiogr 2009; 22 (12): 1338–43. DOI: 10.1016/j.echo.2009.09.016
36. Desai MY, Bhonsale A, Smedira NG et al. Predictors of long-term outcomes in symptomatic hypertrophic obstructive cardiomyopathy patients undergoing surgical relief of left ventricular outflow tract obstruction. Circulation 2013; 128 (3): 209–16. DOI: 10.1161/CIRCULATIONAHA.112.000849
37. Ohe T. Results from the Kochi RYOMA Study. Atrial fibrillation is a major risk of morbidity in patients with hypertrophic cardiomyopathy. Сirculation J 2009; 73 (9): 1589–90. DOI: 10.1253/circj.CJ-09-0433
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39. Ash-Bernal R, Peterson LR. The cardiometabolic syndrome and cardiovascular disease. J Cardiometabolic Syndrome. 2006; 1 (1): 25–8. DOI: 10.1111/j.0197-3118.2006.05452.x
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1 ФГБУ «Национальный медицинский исследовательский центр им. В.А.Алмазова» Минздрава России. 197341, Россия, Санкт-Петербург, ул. Аккуратова, д. 2;
2 ФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. акад. И.П.Павлова» Минздрава России. 197022, Россия, Санкт-Петербург, ул. Льва Толстого, д. 6/8
*anikas1985@gmail.com
1 V.A.Almazov National Medical Research Center. 197341, Russian Federation, Saint Petersburg, ul. Akkuratova, d. 2;
2 I.P.Pavlov First Saint Petersburg State Medical University. 197022, Russian Federation, Saint Petersburg, ul. L'va Tolstogo, d. 6/8
*anikas1985@gmail.com