超声心动图对化学消融术治疗梗阻性肥厚型心肌病疗效评价

Echocardiographic diagnostic value in percutaneous transluminal septal myocardial ablation for hypertrophic obstructive cardiomyopathy

目的:为了探讨超声心动图对梗阻性肥厚型心肌病(HOCM)化学消融术治疗疗效的诊断价值。方法:HOCM患者用超声心动图的方法测量治疗前后的不同时间室间隔基底部的厚度、左室流出道的宽度及左室流出道压力阶差。结果:10例HOCM患者进行了化学消融术治疗,其中7例男性,3例女性,平均年龄55岁,术前室间隔基底部厚度18.5±4mm,左室流出道内径9±4mm,左室流出道压力阶差59±26mmHg。术后1周左室流出道压力阶差平均下降到17.7mmHg,术后1月室间隔厚度15±3mm,左室流出道内径约15±3mm,术后半年与术后1月相比无明显改变。其中1例患者于随访第3年发现左室流出道压力阶差回升至46.8mmHg。结论:超声心动图对于检测梗阻性肥厚型心肌病,评价化学消融术的疗效是一个无创的有价值的检查方法。

Objective：To evaluate the diagnostic value in percutaneous transluminal septal myocareial ablation （PTSMA） for hypertrophic obstructive cardiomyopathy （HOCM） with echocardiography. Methods： Measuring the interventricular septsl thickness （ IVST）, dimension of left ventricular outflow tract （LVOTD） and left ventricular outflow tract pressure gradient （LVOTG）. Results： From 2000 to 2003, 10 patients with HOCM underwent PISMA, 3 were female and 7 were male, mean age of 55 years. The mean reduction of IVST and LVOTG were seen 1 month after the operation from 18.5 ± 4mm to 15 ±3mm and from 59 ± 26mmHg to 17.7 ± 3.5mmHg. There were not much difference between 1 month and 6 months after the operation, but the first ease which LVOTG raised to 46.8 mmHg three years after operation.Conclusion： Echocardiography is a noninvasive tool which provides real-time motion visualization of changes in LVOTG and the curative effect after operation.