肥厚型心肌病患者超声心动指标与危险性室性心律失常的相关性

The Relationship between the Echo cardiogram Finding and Ventricular Arrhythmia in Patients with Hypertrophic Cardiomyopathy

目的:探讨肥厚型心肌病心室肥厚程度、心室舒张功能及左室流出道梗阻程度与室性心律失常的关系。方法:对75例肥厚型心肌病患者进行24h动态心电图检测及心超检查,按照Lown分级法对室性心律失常进行分级,把患者分为A组(非危险性室性心律失常组)与B组(危险性心律失常组)。比较A组与B组患者的左室舒张末内径(LVEDD)、左室收缩末内径(LVESD)、室间隔厚度、左室后壁厚度、E/A等指标,并比较梗阻型与非梗阻型患者危险性室性心律失常的发生率有无差异。结果:A、B两组患者的室间隔厚度、E/A存在显著差异(P<0.05),但LVEDD、LVESD、左室后壁厚度无显著差异;梗阻型患者危险型心律失常的发生率(48.15%)显著高于非梗阻型患者(25%),P<0.05。结论:肥厚型心肌病患者危险性室性心律失常的发生与室间隔厚度、左室舒张功能、流出道梗阻与否显著相关,室间隔越厚、左室舒张功能越低,流出道梗阻越严重,则越易发生危险性室性心律失常。

Objective： To disscuss the relationship between ventricular arrhythmia and the hypertrophic extent, the diastolic function of ventricle, the obstructive extent of aortic vestibule among hypertrophic cardiomyopathy （HCM）patients. Methods： 24-h ECG recordings and echocardiograms of 75 patients with HCM were collected and the patients were divided into two groups（group A and group B） according to Lown gradings of their ventricular arrhythmia. The LVEDD, LVESD, thickness of interventricular septum, oosterior wall of left ventricle, E/A ratio were comoared among two groups. The incidence of dangerous ventricular arrhythmia is also compared between obstructive and non-obstructive HCM. Results： There was significant difference between A and B groups as for interventricular septum thickness and E/A ratio; however, no significant difference was found regarding the LVEDD, LVESD and thickness of posterior wall of left ventricle. Meanwhile, the incidence of dangerous ventricular arrhythmia was significantly higher among obstructive HCM patients（48.15 % ） than non-obstructive HCM patients（25 %）（P〈0.05）. Conclusion： The incidence of dangerous ventrieular arrhythmia is evidently related to interventrivular septum thickness, diastolic function of left ventricle and aortic vestibule obstruction. The thicker the interventrieular septum is, the lower the ventricular diastolic function is, and the more serious the aortic vestibule obstruction is, the more the dangerous ventricular arrhythmia will tend to occur.