肥厚型心肌病患者小动脉弹性指数水平与左心室流出道梗阻的关系

Arterioles elasticity index and left ventricular outflow tract obstruction

目的:探讨肥厚型心肌病(HCM)患者小动脉弹性指数(C2)水平与左心室流出道梗阻的关系。方法:纳入2010年1月至2013年7月间因肥厚型心肌病于我院心内科住院的患者69例,收集相关临床资料,比较C2水平与相关指标的关联性。再根据左心室流出道梗阻情况的不同,将HCM患者分为梗阻性HCM与非梗阻性HCM,比较两组患者的C2水平。结果:N末端B型利钠肽原(NT-proBNP)、左室流出道最大压差(LVOTPG)与C2呈显著负相关,左室短轴缩短率(LVFS)与C2呈显著正相关,左室后壁宽度(LVPWD)与C2无显著相关性,超敏肌钙蛋白I(c-TNI)、左室射血分数(LVEF)、左室舒张末期内径(LVEDD)与C2呈非线性相关。梗阻性HCM患者的C2水平显著低于非梗阻性HCM患者。结论:C2与LVOTPG密切相关,该指标可作为HCM患者左心室流出道梗阻病情进展的动态评价指标。

Objective：To investigate the relationship between arterioles elasticity index （C2） and left ventricular outflow tract obstruction in patients with hypertrophic cardiomyopathy （HCM）.Methods：A total of 69 HCM patients were enrolled in this study from January 2010 to July 2013.General clinical information was collected and correlation between different concentrations of C2 and other related indexes was analyzed.Then,HCM patients were divided into obstructive and non-obstructive HCM groups according to the degree of left ventricular outflow tract obstruction,and C2 level was compared between the two groups.Results：C2 was negatively related to N-terminal pro-brain natriuretic peptide （NT-proBNP） and left ventricular outflow tract maximum pressure （LVOTPG）,and it was positively related to left ventricular fraction shortening （LVFS）.There was no significant correlation between left ventricular posterior wall depth （LVPWD） and C2.C2 was nonlinear correlated to high-sensitivity troponin I（c-TNI）,left ventricular ejection fraction （LVEF） and left ventricular enddiastolic diameter （LVEDD）.Compared with non-obstructive HCM patients,C2 was significantly decreased in obstructive HCM patients.Conclusion：C2 is closely correlated with LVOTPG,and it may be a dynamic evaluation index indicating the obstructive condition of left ventricular outflow tract in HCM patients.