多普勒超声心动图评价肥厚型心肌病左心功能及血流动力学特征

Estimation of left ventricular function and blood flow dynamics in hypertrophy cardiomyopathy patients with Doppler echocardiography

目的 :探讨肥厚型心肌病患者左心功能的变化及影响其血流动力学特征的因素。方法 :应用二维超声心动图测量患者的左心室内径及心室壁厚度 ,并由此估测左心室重量 ;应用多普勒超声心动图测量患者的左室流出道压差 ;心功能测量应用超声AQ技术。结果 :①肥厚型心肌病的左室收缩功能较正常对照组增加(P<0.01) ,左室舒张功能较正常对照组减低(P<0.01)。②肥厚型梗阻性心肌病的左室舒张功能较肥厚型非梗阻性心肌病减低(P<0.05～0.01)。③肥厚型梗阻性心肌病的LVPG与IVST及左室收缩功能指标呈中度正相关(r=0.52～0.57,P<0.05)。结论 :肥厚型心肌病的左室收缩功能增强 ,左室舒张功能减低 ,随着左室流出道梗阻的出现 ,左室舒张功能进一步减低 ;肥厚型心肌病患者的左室梗阻性可能与室间隔厚度的增加及左室收缩功能的增强有关。

Objective:To detect left ventricular systolic and diastolic function and factors influence blood flow dynamics in hypertrophy cardiomyopathy(HCM) patients. Methods:LVDD、IVST、PWT、LVPG measurements using echocardiography;left ventricular outflow tract gradient measurements using Doppler echocardiography;left ventricular function measurements using acoustic quantification (AQ) technology.Results:①Left ventricular systolic function in HCM group was significantly higher than that in normal group(P<0.01); Left ventricular diastolic function in HCM group was significantly lower than that in normal group (P<0.01).②Left ventricular diastolic function in left ventricular outflow tract obstruction HCM group was significantly lower than that in left ventricular outflow tract non-obstruction HCM group (P<0.05～0.01).③LVPG of left ventricular outflow tract obstruction HCM group had positive correlation with IVST、LV-EF、LV-PERv(r=0.53,0.57,0.52 respectively,P<0.05),and it had no correlation with IVST:PWT ratio.Conclusion:Left ventricular systolic function in HCM patients was increased,and left ventricular diastolic function in it was decreased.Left ventricular diastolic function was further decreased in left ventricular outflow tract obstruction HCM patients.The obstruction machanism of left ventricular outflow tract may had relationship with IVST and the increase of left ventricular systolic funetion.