CURRENT APPROACHES TO TREATING PATIENTS WITH PRIMARY HYPERTROPHIC CARDIOMYOPATHY
Objective. To develop an algorithm for selecting the scheme for treating patients with hypertrophic cardiomyopathy (HCMP) (medicamentous, electrophysiological, and surgical). Materials and methods. One hundred and fifty patients with HCMP (mean age - 43.5 ± 6.5 years) participated in the study. Every patient had undergone a complex examination including the genealogic analysis, the physical examination, electrocardiography (ECG) in 12 leads, the ECG 24-hour monitoring, echocardiography and bicycle test, coronary angiography when indicated. Results. A diagnostic algorithm for selecting the scheme for treating patients with HCMP (medicamentous, electrophysiological, and surgical) had been developed. Groups at risk for sudden cardiac death were separated among the patients having life threatening ventricular arrhythmias. Positive effects of various schemes of long-time medicamentous therapy on the clinical manifestations, the hemodynamics values, the ECG 24-hour monitoring parameters were shown. An algorithm for selecting the technique for surgical interference depending on the HCMP course morphological variant and the obstruction pathophysiologic features was developed. Conclusion. The algorithm developed for selecting the treatment scheme allows achieve a good clinical effect, prevent severe complications appearance, and improve prognosis for a significant part of patients with HCMP.