BACKGROUND Non-cardiac surgery for hypertrophic obstructive cardiomyopathy (HOCM) is considered to require meticulous perioperative care. β-blockers are considered the first-line drugs for patients with HOCM, and they play a key role in preventing cardiovascular complications in perioperative care. The bisoprolol transdermal patch has recently become available in Japan, and it is useful for patients who are unable to take oral medication during perioperative care. The aim of this case series was to assess the hemodynamic features of patients with HOCM who used the bisoprolol transdermal patch during perioperative care for non-cardiac surgery. METHODS Between August 2016 and August 2018, we retrospectively analyzed 10 consecutive cases of HOCM with the patients using the bisoprolol transdermal patch during perioperative care. Hemodynamic and echocardiographic features were evaluated before and after patients were switched from oral bisoprolol to transdermal patch therapy or started transdermal patch therapy as a new β-blocker medication. In addition, cardiovascular complications (all-cause death, cardiac death, heart failure, ventricular tachycardia, and ventricular fibrillation) during the perioperative period were evaluated. RESULTS There was no significant change in the patients' heart rate, blood pressure, ejection fraction, and pressure gradient in the left ventricle after switching from oral bisoprolol to the transdermal patch therapy. On the other hand, patients who started using the bisoprolol transdermal patch as a new ß-blocker medication tended to have a decreased heart rate and pressure gradient thereafter, but there was no significant difference in blood pressure or ejection fraction. No cardiovascular complications occurred during the perioperative period. CONCLUSIONS We described the utilization of the bisoprolol transdermal patch during perioperative care for non-cardiac surgery in patients with HOCM. We determined that the hemodynamic features of these patients did not change significantly after switching to patch therapy. Further, initiation of the bisoprolol transdermal patch as a new ß-blocker medication sufficiently tended to decrease the pressure gradient. This unique approach can be an alternate treatment option for HOCM. TRIAL REGISTRATION The registry was registered in the University Hospital Medical Information Network Clinical Trials Registry (UMIN000036703). The date of registration was 10/5/2019 and it was "Retrospectively registered".

中文翻译：

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比索洛尔透皮贴剂用于肥厚性梗阻性心肌病患者的非心脏手术围手术期护理。

背景技术肥厚性梗阻性心肌病（HOCM）的非心脏手术被认为需要仔细的围手术期护理。β受体阻滞剂被认为是HOCM患者的一线药物，在围手术期护理中预防心血管并发症起着关键作用。比索洛尔透皮贴剂最近已在日本上市，对于围手术期护理中无法口服药物的患者很有用。本病例系列的目的是评估非心脏手术围手术期使用比索洛尔透皮贴剂的HOCM患者的血液动力学特征。方法在2016年8月至2018年8月期间，我们回顾性分析了10例HOCM的围手术期护理中使用比索洛尔透皮贴剂的患者。在将患者从口服比索洛尔转为经皮贴剂治疗或作为新的β受体阻滞剂开始经皮贴剂治疗之前和之后，评估了血流动力学和超声心动图特征。此外，还评估了围手术期的心血管并发症（全因死亡，心源性死亡，心力衰竭，室性心动过速和室颤）。结果从口服比索洛尔改为经皮贴剂治疗后，患者的心率，血压，射血分数和左心室压力梯度无明显变化。另一方面，开始使用比索洛尔透皮贴片作为新的β-受体阻滞剂的患者此后心率和压力梯度趋于降低，但血压或射血分数无明显差异。围手术期未发生心血管并发症。结论我们描述了比索洛尔透皮贴剂在HOCM患者非心脏手术围手术期护理中的应用。我们确定这些患者的血液动力学特征在改用贴片治疗后没有明显改变。此外，比索洛尔透皮贴剂作为一种新的β-受体阻滞剂的启动足以降低压力梯度。这种独特的方法可以作为HOCM的替代治疗选择。试验注册该注册已在大学医院医学信息网络临床试验注册中心（UMIN000036703）中注册。注册日期为10/5/2019，它是“