Objective: To investigate the clinical characteristics of patients with hypertrophic cardiomyopathy (HCM) and restrictive cardiomyopathy (RCM) complicating with intracardiac thrombosis. Methods: This is a retrospective observational study. Consecutive patients diagnosed with HCM or RCM and complicated with intracardiac thrombosis (including left and right atrium or ventricular thrombosis), who were admitted to the Heart Failure Care Unit of Fuwai Hospital, Chinese Academy of Medical Sciences, from September 2008 to September 2018, were enrolled in this study. Patients with myocardial infarction were excluded. The general clinical data of the enrolled patients, including demographic data, major complications, laboratory indicators, echocardiographic indicators, drug application and distribution of intracardiac thrombosis, were collected from electronic medical record system and analyzed. Results: A total of 98 patients were enrolled in this study, including 52 patients (53.1%) with HCM and 46 patients (46.9%) with RCM. The most common comorbidity was atrial fibrillation/flutter: 40 patients (76.9%) in HCM group and 36 patients (78.3%) in RCM group. Majority of patients received oral anticoagulants treatment: 43 patients (82.7%) in HCM group and 35 patients (76.1%) in RCM group. Intracardiac thrombosis was mainly located in the left atrium in both HCM group (39 cases (75.0%)) and RCM group (32 cases (69.6%)). Thrombosis was found in ≥ 2 chambers in 7 patients (7.1%). Rate of left atrial thrombosis was the highest (81.6% (62/76)) in HCM and RCM patients complicating with atrial fibrillation/flutter. Intra-aneurysmal thrombosis occurred in 4 out of 5 patients complicated with apical left ventricular aneurysm. The rate of left ventricular thrombosis in patients with left ventricular ejection fraction≥50% was 7.4% (4/54), which was significantly lower than that in patients with left ventricular ejection fraction<50% (34.5%(10/29)) (P<0.01). Conclusion: There are certain distribution characteristics of HCM and RCM patients with intracardiac thrombosis, and the left atrium is the most common site of thrombosis, more attention should be paid in HCM and RCM patients on the diagnosis and treatment of intracardiac thrombosis.
目的： 分析合并心内血栓的肥厚型心肌病（HCM）和限制型心肌病（RCM）患者的临床特点。 方法： 该研究为回顾性观察性研究。连续入选2008年9月至2018年9月于中国医学科学院阜外医院心力衰竭中心重症监护病区住院的HCM或RCM且合并心内血栓（包括左、右心房或心室血栓）的患者，排除心肌梗死患者。通过电子病历系统收集入选患者的一般临床资料，包括人口学资料、主要合并症、实验室指标、超声心动图指标、药物应用及心内血栓分布等资料，并对其进行分析。 结果： 研究共入选患者98例，其中HCM患者52例（53.1%），RCM患者46例（46.9%）。合并症中最常见的是心房颤动（房颤）/心房扑动（房扑），HCM和RCM患者中分别有40例（76.9%）和36例（78.3%）。入选患者中接受口服抗凝药治疗者比例较高，HCM和RCM患者中分别有43例（82.7%）和35例（76.1%）。HCM和RCM患者心内血栓均主要分布于左心房，分别有39例（75.0%）和32例（69.6%）。入选患者中7例（7.1%）为多部位血栓。合并房颤/房扑的患者左心房血栓的分布比率最高，达81.6%（62/76）。5例合并左心室心尖部室壁瘤的患者4例发生瘤内血栓。左心室射血分数≥50%的患者左心室血栓的比率为7.4%（4/54），明显低于左心室射血分数<50%患者的34.5%（10/29）（P<0.01）。 结论： 合并心内血栓的HCM和RCM患者血栓分布具有一定的规律，左心房是血栓的最常见部位。.