探讨梗阻性与非梗阻性肥厚型心肌病左心室应变力的差异
发布时间：2018-11-13 13:00
【摘要】：目的·探讨梗阻性与非梗阻性肥厚型心肌病(HCM)患者左心室应变力的改变及其差异。方法·序贯入组48例左心室射血分数保留(LVEF50%)的HCM(梗阻性18例、非梗阻性30例)和25例健康人,采用心脏磁共振成像(MRI)扫描,测量并比较左心室整体纵向应变(GLS)、径向应变(GRS)与周向应变(GCS),以及LVEF、左室舒张末容积(LVEDV)、左室心肌质量(LVM)、左室舒张末容积指数(LVEDVI)、左室心肌质量指数(LVMI)。依据美国心脏协会17节段法则测量左心室中段径向应变(m RS)、周向应变(m CS)及径向最大位移。结果·(1)梗阻性HCM患者LVEF显著高于非梗阻性及正常组(P0.05),2组HCM患者LVM及LVMI均显著高于正常组(均P0.01)。(2)与梗阻性HCM患者相比,非梗阻性HCM患者的左心室整体应变参数(GLS、GRS、GCS)均明显降低(均P0.05),且2组均低于正常组,差异具有统计学意义(均P0.05)。(3)与梗阻性HCM患者相比,非梗阻性HCM患者的左心室节段性心肌应变力,即左心室m CS及m RS显著降低(均P0.05),且2组均低于正常组(均P0.05)。非梗阻性HCM患者左心室中段心肌径向最大位移显著低于梗阻性HCM患者及正常组(均P0.05),梗阻性HCM患者与正常组间差异无统计学意义(P0.05)。结论·在LVEF保留情况下,非梗阻性HCM患者左心室壁应变力较梗阻性HCM患者显著降低,可能是导致2种类型HCM患者临床预后不同的原因,提示在评价HCM心肌做功方面,心室室壁应变力较射血分数更敏感。
[Abstract]:Objective to investigate the changes and differences of left ventricular strain in patients with obstructive and non obstructive hypertrophic cardiomyopathy (HCM). Methods the left ventricular ejection fraction (LVEF50%) HCM (18 obstructive, 30 non-obstructive) and 25 normal controls were examined by (MRI) scanning with cardiac magnetic resonance imaging (MRI) in 48 patients with sequential left ventricular ejection fraction retention (LVEF50%). Measurement and comparison of left ventricular global longitudinal strain (GLS), radial strain (GRS) and circumferential strain (GCS), and LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular mass (LVM), left ventricular end-diastolic volume index (LVEDVI), Left ventricular mass index (LVMI).) Radial strain (m RS), circumferential strain (m CS) and radial maximum displacement were measured according to the American Heart Association 17 segment rule. Results (1) the LVEF of obstructive HCM patients was significantly higher than that of non-obstructive HCM patients and normal controls (P0.05). The LVM and LVMI of HCM patients in both groups were significantly higher than those in normal controls (P0.01). (2), and those in obstructive HCM patients were significantly higher than those in obstructive HCM patients. The global strain parameters (GLS,GRS,GCS) of left ventricle in patients with non-obstructive HCM were significantly decreased (P0.05), and the two groups were lower than the normal group (P0.05). (3). The left ventricular segmental strain, that is, left ventricular m CS and m RS in patients with non-obstructive HCM was significantly decreased (P0.05), and both groups were lower than normal group (P0.05). The maximum radial displacement of left ventricular myocardium in patients with non-obstructive HCM was significantly lower than that in patients with obstructive HCM and normal controls (P0.05), but there was no significant difference between patients with obstructive HCM and normal controls (P0.05). Conclusion under the condition of LVEF retention, left ventricular wall strain in patients with non-obstructive HCM is significantly lower than that in patients with obstructive HCM, which may be the cause of the difference in clinical prognosis between the two types of HCM patients. Ventricular wall strain is more sensitive than ejection fraction.
【作者单位】： 上海交通大学医学院;上海交通大学附属第六人民医院心脏中心;
【基金】：上海市卫生局科研课题计划项目(20134105)~~
【分类号】：R542.2
本文编号：2329177
[Abstract]:Objective to investigate the changes and differences of left ventricular strain in patients with obstructive and non obstructive hypertrophic cardiomyopathy (HCM). Methods the left ventricular ejection fraction (LVEF50%) HCM (18 obstructive, 30 non-obstructive) and 25 normal controls were examined by (MRI) scanning with cardiac magnetic resonance imaging (MRI) in 48 patients with sequential left ventricular ejection fraction retention (LVEF50%). Measurement and comparison of left ventricular global longitudinal strain (GLS), radial strain (GRS) and circumferential strain (GCS), and LVEF, left ventricular end-diastolic volume (LVEDV), left ventricular mass (LVM), left ventricular end-diastolic volume index (LVEDVI), Left ventricular mass index (LVMI).) Radial strain (m RS), circumferential strain (m CS) and radial maximum displacement were measured according to the American Heart Association 17 segment rule. Results (1) the LVEF of obstructive HCM patients was significantly higher than that of non-obstructive HCM patients and normal controls (P0.05). The LVM and LVMI of HCM patients in both groups were significantly higher than those in normal controls (P0.01). (2), and those in obstructive HCM patients were significantly higher than those in obstructive HCM patients. The global strain parameters (GLS,GRS,GCS) of left ventricle in patients with non-obstructive HCM were significantly decreased (P0.05), and the two groups were lower than the normal group (P0.05). (3). The left ventricular segmental strain, that is, left ventricular m CS and m RS in patients with non-obstructive HCM was significantly decreased (P0.05), and both groups were lower than normal group (P0.05). The maximum radial displacement of left ventricular myocardium in patients with non-obstructive HCM was significantly lower than that in patients with obstructive HCM and normal controls (P0.05), but there was no significant difference between patients with obstructive HCM and normal controls (P0.05). Conclusion under the condition of LVEF retention, left ventricular wall strain in patients with non-obstructive HCM is significantly lower than that in patients with obstructive HCM, which may be the cause of the difference in clinical prognosis between the two types of HCM patients. Ventricular wall strain is more sensitive than ejection fraction.
【作者单位】： 上海交通大学医学院;上海交通大学附属第六人民医院心脏中心;
【基金】：上海市卫生局科研课题计划项目(20134105)~~
【分类号】：R542.2
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