摘要
目的探讨应用定量组织速度成像技术(QTVI)评价肥厚型心肌病(HCM)患者左心室非同步舒张运动的意义。方法获取15例非梗阻性HCM(HCM)患者、12例梗阻性HCM(HOCM)患者及14例正常人的标准心尖部左室长轴、两腔和四腔观组织速度图像,离线分析左心室6个壁基底段、中间段和心尖段共18个位点及左心室各壁二尖瓣环的组织速度曲线,测量心电图QRS波起始点至各位点心肌舒张早期峰值速度(Ea)的时限(TQ-E)。计算同一节段6个壁间TQ-E的最大差值(Inter-ΔTQ-E)、同一壁内3个节段间TQ-E的最大差值(Intra-ΔTQ-E)及左心室18个位点间TQ-E的最大差值(Max-ΔTQ-E)。计算左心室各壁二尖瓣环Ea与舒张晚期峰值速度(Aa)比值的平均值(Ea/Aa′)。并测定室间隔基底段厚度(IVSTh)与左心室流出道压力阶差(LVOTPG)。结果与正常人相比,HCM和HOCM患者的Inter-ΔTQ-E、Intra-ΔTQ-E、Max-ΔTQ-E均明显延长,Ea/Aa′明显降低;而HCM和HOCM患者之间Inter-ΔTQ-E、Intra-ΔTQ-E、Max-ΔTQ-E、Ea/Aa′无明显不同。IVSTh、LVOTPG在正常人、HCM和HOCM患者中依次递增。HCM和HOCM患者中,Max-ΔTQ-E与Ea/Aa′均呈显著负相关。HCM患者IVSTh、LVOTPG与Ea/Aa′未见明显相关,而HOCM患者IVSTh、LVOTPG与Ea/Aa′呈中度负相关。结论HCM患者左心室同一节段、同一壁内均存在非同步舒张运动,并且其是导致左心室舒张功能不全的必要因素,而IVSTh、LVOTPG则不是导致HCM患者左心室舒张功能不全的必要因素;HCM患者左心室不同步舒张运动可能在一定程度上反映了其心肌病变。
Objective To evaluate the diastole asynchrony of the different segments of left ventricle（LV） and its relation with LV diastole function in the patients with hypertrophic cardiomyopathy （HCM） by quantitative tissue velocity imaging（QTVI）. Methods Forteen normal controls, 15 patients with non-obstructive HCM （HCM） and 12 patients with obstructive HCM （HOCM） were studied by QTVI. The regional velocity profiles of 18 segments of LV and mitral annulus of six walls along LV apical long axis view, apical two chamber view and four chamber view were obtained. The time （TQ-E） from onset of QRS complexes to peak velocity during early diastole were measured. The maximal difference in TQ-E with in the same wall （Intra-△TQ-E）, the same segment （Inter-△TQ-E）, all 18 segments （Max-△TQ-E） of LV and the mean ratio of mitral annulus early and late diastole peak velocity of six walls were calculated（Ea/Aa＇）. Interventricular septum basic thickness（IVSTh） and LV outflow tract gradient （LVOTPG） were measured. Results Inter-△TQ-E, Intra-△TQ-E, Max-△TQ-E were significantly prolonged and Ea/Aa＇ was reduced in HCM and HOCM groups compared with control group. There was no statistically significant difference of Inter-△TQ-E, Intra-△TQ-E, Max-△TQ-E, Ea/Aa＇ between HCM and HOCM groups. In control group, HCM group, HOCM group,IVSTh and LVOTPG were increased little by little. Max-△TQ-E were correlated negatively with Ea/Aa＇ in patients with HCM and HOCM. IVSTh and LVOTPG were mildly correlated with Ea/Aa＇ in HOCM group, but not correlated with Ea/Aa＇ in HCM. Conclusions Asynchrony diastole is a neccessary factor causing impairment of LV diastole function exists within the same wall and the same segment of LV in patients with HCM, but IVSTh and LVOTPG is not a neccessary factor causing impairment of LV diastole function. Asynchrony diastole in patients with HCM could be an appereance of cardiomyopathy.
出处
《中华超声影像学杂志》
CSCD
2006年第6期405-407,共3页
Chinese Journal of Ultrasonography
关键词
超声心动描记术
心肌病
肥厚性
心室功能
左
Echocardiography
Cardiomyopathy, hypertrophic
Ventricular function, left
