肥厚梗阻型心肌病化学消融术后早期左心形态重构和电重构

Early left heart shape remodeling and electrical remodelingafter percutaneous transluminal septal myocardial ablation in patients with hypertrophic obstructive cardiomyopathy

目的探讨肥厚梗阻型心肌病(hypertrophic obstructive cardiomyopathy,HOCM)在经皮经冠脉间隔心肌化学消融术(PTSMA)后早期左心几何构型和电生理的变化。方法 32例行PTSMA的HOCM患者,比较术前及术后1个月、6个月经胸超声心动图及心电图测量指标的变化。结果与术前相比,患者术后1个月、6个月时室间隔厚度(IVS)、V1导联P波终末电势(Ptf V1)明显下降;术后6个月左房收缩末期内径(LAD)下降,左室舒张末期内径(LVD)增加,差异均有统计学意义(P<0.05)。术后1个月病理性Q波例数较术前明显增加,差异有统计学意义(P<0.001)。结论 PTSMA是HOCM的有效治疗方法,早期逆转了HOCM患者的心脏重构。

Objective To investigate the early changes of geometric configurations and electrophysiology after percutaneous transluminal septal myocardial ablation（ PTSMA） in patients with hypertrophic obstructive cardiomyopathy（ HOCM）. Methods The PTSMA was performed in 32 patients with HOCM.All patients received echocardiography and electrocardiogram（ ECG） examination before operation and after 1 and 6 months of PTSMA.Results In one month and six months after PTSMA,the thickness of interventricular septum（ IVS） and p-wave terminal force-v1（ Ptf V1） were decreased.In six months after PTSMA,the dimensions of the left atrium（ LAD）was reduced while left ventricular（ LVD） were increased（ P 〈0. 05）.the pathologic Q wave were increased significantly after 1 month of operation（ P〈 0. 001）.Conclusion PTSMA is an effective treatment for patients with HOCM and can reverse cardiac remodeling at the early stage.