多普勒组织成像评价肥厚型心肌病左室舒张功能

Assessment of left ventricular diastolic function in hypertrophic cardiomypathy with Doppler tissue imaging

目的应用多普勒组织成像脉冲技术测量二尖瓣环舒张速度,以评价肥厚型心肌病左室舒张功能.方法对90例肥厚型心肌病患者及50例正常人进行常规超声心电图及多普勒组织成像检查,测量各房室内径,室壁厚度,射血分数及二尖瓣环各点舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa).两组指标比较采用成组t检验.结果肥厚型心肌病患者室间隔厚度(25.5±6.6)mm,左室后壁厚度(9.9±2.3)mm,左室内径(42.9±5.9)mm,左房内径(39.9±4.7)mm,LVEF(71.9±4.3)%,二尖瓣血流E/A为1.42±0.7.肥厚型心肌病患者Ea较正常人减低.Aa无明显差异.结论肥厚型心肌病左室长轴主动松弛功能较正常人减低.

Objective To evaluate left ventricular diastolic function in patients with hypertrophic cardiomypathy （HCM）with Doppler tissue imaging. Methods The diameters of atrail and ventricle, LVEF and E/A were recorded with the use of ultrasound in 90 patients with hypertrophic cardiomyopathy and 50 normal volunteers. And we measured the peak diastolic velocities of mitral annulus by Doppler tissue imaging using the apical window at 4- chamber, 2-chamber and long apical views, respectively. The myocardial velocities were determined with the use of analysis of grouped t test. Results The interventricular septal thickness（IVST）, left ventricular posterior wall （LVPW）, left ventricle（LV）, left atrial diameter （LA）, left ventricular ejection fraction （LVEF） and E/A were （25.5±6.6）mm,（9.9±2.3）mm,（42.9±5.9）mm, （39.9±4.7）mm, （71.9±4.3）%,（1.42±0.7）, respectively. Early diastolic myocardial velocities of mitral annulus （Ea） were higher in normal subjects than those in patients with hypertrophic cardiomyopathy. However, peak myocardial velocities of mitral annulus during atrial contraction （Aa） were similar between normal subjects and patients with HCM. Conclusions HCM patients have impaired left ventricular diastolic function. Doppler tissue imaging is an accurate and sensitive method for identifying left ventricular diastolic function in patients with HCM.