高频超声对扩张型心肌病颈动脉结构和功能及其相关性的研究

Evaluation of carotid arterial structure and function in patients with dilated cardiomyopathy using high-frequency ultrasonography

目的 评价扩张型心肌病患者颈动脉弹性和内中膜复合体厚度变化及其之间的关系。方法 应用高频超声检测 19例扩张型心肌病患者和 18例正常对照者颈动脉弹性和内中膜复合体厚度 (IMT)。颈动脉弹性用Ep(弹性指数 )和 β(僵硬度 )表示。结果 扩张型心肌病患者颈动脉Ep[( 1.78± 1.0 4)N/m2 × 10 6]和 β( 2 5 .5 6± 13 .3 3 )显著高于正常人 [( 0 .5 7± 0 .2 6)N/m2 × 10 6,P <0 .0 0 1;8.74± 4.17,P <0 .0 0 1] ,内中膜复合体厚度 [( 0 .95± 0 .12 )mm]也显著大于正常人 [( 0 .76±0 .12 )mm ,P <0 .0 0 1]。正常组中 ,IMT与Ep(r=0 .62 ,P =0 .0 0 6)和 β(r =0 .65 ,P =0 .0 0 3 )分别相关 ;扩张型心肌病组中 ,IMT亦与Ep(r =0 .82 ,P <0 .0 0 1)和 β(r =0 .80 ,P <0 .0 0 1)分别相关。 结论 扩张型心肌病患者颈动脉弹性减低 ,内中膜复合体厚度增加。

Objective To assess the carotid arterial compliance and intimal-medial thickness (IMT) in patients with dilated cardiomyopathy using high-frequency ultrasonography. Methods Carotid arterial compliance and IMT were measured by high-frequency ultrasonography in 19 patients with dilated cardiomyopathy and 18 healthy subjects. Carotid arterial compliance was shown by pressure-strain elastic modulus (Ep) and stiffness index beta (β). Results Ep [(1.78±1.04) N/m^2×10~6] and β (25.56±13.33) were significantly higher in patients with dilated cardiomyopathy than in healthy subjects [(0.57±0.26) N/m^2×10~6, P<0.001; 8.74±4.17, P<0.001, respectively]. Carotid arterial IMT [(0.95±0.12) mm] was thicker in patients with dilated cardiomyopathy than in healthy subjects [(0.76±0.12) mm, P< 0.001]. In healthy subjects, IMT positively correlated with Ep (r=0.62, P=0.006) and β (r=0.65, P=0.003), respectively. IMT positively correlated with Ep (r=0.82, P<0.001) and β (r=0.80, P<0.001), respectively, in patients with dilated cardiomyopathy. Conclusion It demonstrated that decreased carotid arterial compliance parameters and increased carotid IMT exist in patients with dilated cardiomyopathy, and that there is a good relationship between carotid arterial structure and function. [