非梗阻性与梗阻性肥厚型心肌病的临床及影像对照研究

Clinical and imaging study of non-obstructive hypertrophic cardiomyopathy and obstructive hypertrophic cardiomyopathy

目的探讨非梗阻性肥厚型心肌病(NOHCM)与梗阻性肥厚型心肌病(OHCM)的临床及MRI、US心功能表现的异同。方法选取并分为NOHCM组40例与OHCM组81例患者的临床资料、实验室检查、MRI及US心功能参数特点,比较两组间差异性。结果NOHCM组与OHCM组在临床中的胸痛、呼吸困难、心脏杂音和MRI心功能参数中的左心室壁最大厚度(LVMWT)、左右心室射血分数(EF)、左右心室收缩末期容积(ESV)差异有统计学意义(P<0.05),而在US心功能参数差异无统计学意义(P>0.05)。结论OHCM组相对NOHCM组临床症状重、心脏杂音比例高、左心室壁肥厚程度大,NOHCM心室收缩功能损害愈加明显。MRI较US更有助于心功能的评估。

Objective To investigate the similarities and differences in clinical,MRI and ultrasound cardiac functions of non-obstructive hypertrophic cardiomyopathy(NOHCM)and obstructive hypertrophic cardiomyopathy(OHCM).Methods The clinical status,laboratory examination,MRI and ultrasound cardiac function parameters of 40 patients with NOHCM and 81 patients with OHCM were retrospectively analyzed,and the differences between the two groups were compared.Results NOHCM and OHCM showed statistically significant differences in chest pain,dyspnea,cardiac murmurs,maximum left ventricular wall thickness in MRI,left and right ventricular ejection fraction(EF)in MRI,and left and right ventricular end-systolic volume(ESV)in MRI(P<0.05),while there was no significant difference in cardiac function parameters in ultrasound(P>0.05).Conclusion Compared with NOHCM,OHCM has more severe clinical symptoms,higher proportion of cardiac murmur,greater degree of left ventricular wall hypertrophy,and more obvious damage to NOHCM ventricular systolic function.MRI is more helpful to the evaluation of cardiac function than ultrasound.