二维斑点追踪成像评估肥厚型心肌病患者室间隔形态对左心室旋转和扭转的影响

Effect of morphology of interventricular septum on left ventricular rotation and torsion in hypertrophic cardiomyopathy using speckle-tracking imaging

目的:探讨应用二维斑点追踪成像评估肥厚型心肌病(HCM)患者室间隔形态对左室旋转和扭转的影响。方法:对22例HCM患者和12例正常人行超声心动图检查并将HCM患者分为C型室间隔肥厚组和反C型室间隔肥厚组。常规超声测定左房大小(LAD),左室心肌最大舒张末期厚度(LVWmax),左室收缩末期容积(LVESV)和舒张末期容积(LVEDV),左室射血分数(LVEF);测量左室基底部和心尖部收缩期整体峰值旋转角度,计算左室收缩期峰值扭转角度。结果:与对照组相比较,两组HCM患者的LAD、LVWmax和左室基底部旋转角度、左室扭转角度和C型室间隔肥厚组左室心尖部旋转角度增加,LVESV和LVEDV减少;与反C型室间隔肥厚组相比较,C型室间隔肥厚组左室心尖部旋转角度和左室心肌扭转角度增加。结论:HCM患者旋转和扭转发生明显改变,其可能是心肌收缩功能受损的代偿机制。

Objective To evaluate the effect of morphology of interventricular septum （IVS） on left ventricular （LV） rotation and torsion in hypertrophic cardiomyopathy （HCM） by using speckle-tracking imaging. Methods Twenty-two HCM patients and 12 healthy controls were enrolled in this study. Echocardiography was performed in all the patients and the healthy controls. The HCM patients were divided into two groups： the sigmoidal group and the reverse group, according to the echocardiographic features. The left atrium dimension （LAD）, the max of LV wall （LVWmax）, end-diastolic volume of LV （LVEDV）, end-systolic volume of LV （LVESV）, ejection fraction of LV （LVEF）, The basal rotation （BR）, apical rotation （AR） and torsion of LV were determined. Results Compared with the healthy controls, LAD, LVWmax, BR and torsion in the HCM patients and AR in the sigmoidal group were increased, but LVEDV and LVESV were decreased in the above two groups. Compared with the reverse group, AR and torsion in the sigmoidal group were increased. Conclusion The rotation and torsion were significantly changed in the HCM patients, which may be a compensatory mechanismfor heart dysfunction.