组织多普勒技术定量分析肥厚型心肌病患者左心室局部与整体舒缩功能

Quantitative analysis of regional and global left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy by Doppler tissue imaging

目的:应用多普勒组织成像技术(DTI)评价肥厚型心肌病患者(HCM)左心室局部与整体舒缩功能。方法:采用DTI技术测量HCM患者室间隔和左心室侧壁中段以及二尖瓣瓣环-室间隔和二尖瓣瓣环-侧壁交界处的收缩期、舒张早期和舒张晚期DTI速度峰值(Sm1～4、Em1～4、Am1～4),并与正常组进行比较。结果:HCM患者室间隔和侧壁中段以及二尖瓣瓣环-室间隔和二尖瓣瓣环-侧壁交界处收缩期Sm1～4与正常组相比无显著差异,但舒张早期Em1～4明显低于正常,舒张晚期Am1～4明显高于正常,Em1～4/Am1～4明显减低;在正常人中,Em1/Am1和Em2/Am2无显著性差异(P>0.05),但HCM患者Em1/Am1明显低于Em2/Am2(P<0.05),且该组患者室间隔厚度明显大于侧壁厚度(2.36±0.50)cmvs(1.20±0.23)cm,P<0.05。结论:DTI技术测量的室壁运动速度可早期而准确反映HCM患者左心室舒缩功能的变化,为左心室舒缩功能的评价提供了一种新的方法。

Objective:To quantitatively analyze r eg ional and global left ventricular systolic and diastolic function in patients wi th hypertrophic cardiomyopathy(HCM)by Doppler tissue imaging(DTI).Meth ods :Seventeen patients with HCM and thirteen control subjects were studied using D TI.DTI data were acquired from medium segments of interventricular septum and lateral wall as well as septum and lateral mitral annulus from four-chamber vie ws.Results:Myocardial segments in patients with HCM had,in comparison with co ntrols,lower peak velocity of the early diastolic wave(Em),higher peak veloc ity of the late diastolic wave(Am)and decreased Em/Am ratio.But there was n o difference in peak velocity of systolic wave.Conclusion:Regional and global left ventricular diastolic function in HCM patients decreases.DTI has more use ful noninvasive modality for the early recognition of left ventricular function in patients with HCM.