组织多普勒成像评价肥厚型心肌病患者心脏舒张功能

Evaluation of the diastolic function in patients with hypertrophic cardiomyopathy by tissue Doppler imaging

目的探讨组织多普勒成像评价肥厚型心肌病舒张功能的价值。方法回顾性对比分析肥厚型心肌病组（60例）及正常对照组（30例）超声心动图检查结果，比较组织多普勒参数与常规超声参数评估左室舒张功能的价值。结果肥厚型心肌病组左心房前后径、面积、室间隔厚度、室间隔与左室后壁厚度比值（IVS／LVPW）、二尖瓣E峰速度与二尖瓣环舒张早期峰值速度比值（E／Em）和左心室充盈压均显著高于对照组（P〈0．01），E／A在两组差异无统计学意义（P=0．67），Em显著低于对照组[（7．84±2．43）cm／s对（10．87±2．18）cm／s，P〈0．01]。肥厚型心肌病组E／Em与左房前后径及面积有相关关系（分别r=0．331，P=0．017；r=0．325，P=0．019），而E／A与二者无相关性。结论组织多普勒参数（Em，E／Em）是评价肥厚型心肌病患者心脏舒张功能的敏感方法。

Objective To investigate the diagnostic value of tissue Doppler imaging（TDI） for diastolic function in hypertrophic cardiomyopathy （HCM）. Methods Sixty patients with HCM and thirty age-matched control were enrolled in this study. Parameters of conventional echocardiogram and TDI were compared. Results In the HCM group, left atrial diameter, left atrial area, thickness of inter-ventricular septum（IVS）, ratio of IV＇S to left ventricular posterior wail （IVS/LVPW）, E/Era and left ventricular filling pressure were statistically higher than those of control group （ P 〈0.01, respectively）, Em was significantly lower（ P 〈0.01 ）. There was no statistical difference on E/A between HCM and control group （ P = 0.67）. E/Era was correlated positively with left atrial diameter and area in the HCM group（r = 0.331, P = 0.017; r = 0.325, P = 0.019,respectively）. However, E/A had no statistical correlation with left atrial diameter and area （ r = 0. 205, P = 0. 142; r = 0. 255, P = 0. 066,respectively）. Conclusions Compared with the conventional Doppler echocardiogram, the parameters of TDI （Era,E/Era） were more sensitive in evaluation of diastolic function in HCM patients.