美托洛尔治疗肥厚型心肌病心功能变化的临床研究

目的评估美托洛尔治疗肥厚型心肌病（HCM）心脏功能的变化情况并探讨有效的超声心动图检查方法。方法选取首次确诊为肥厚型心肌病的患者31例,口服美托洛尔治疗6个月,采用二维和多普勒超声心动图对治疗前后心脏功能变化进行评估,分别测量以下指标：左心房前后径（LAd）、左心房收缩末容积（LAV）;二尖瓣口舒张早期及晚期血流峰值速度（E、A）,E/A值,E峰减速时间（EDT）;二尖瓣环收缩期运动速度（Sm）、舒张早期和舒张晚期运动速度（Em,Am）、Em/Am、E/Em,数据进行统计学分析。结果美托洛尔治疗6个月后HCM患者临床症状明显改善;治疗前HCM患者LAd、LAV明显增大,EDT延长,Em、Em/Am明显下降,E/Em增加,治疗后上述指标明显改善。结论美托洛尔治疗HCM能明显改善患者心功能和临床症状,组织多普勒超声是有效、敏感评估心脏功能的方法 ,研究结果具有重要临床意义。

Evaluation of cardiac functional changes after Metoprolol therapy in patients with hypertrophic cardiomyopathy

Objective To investigate the changes of cardiac function in patients with hypertrophic cardiomyopathy(HCM) after Metoprolol therapy and effective echocardiography examination.Methods 31 patients first diagnosed as HCM were enrolled into the study,each patient was given oral Metoprolol therapy for 6 months,standard 2-dimensional echocardiography,mitral inflow(MIF) and tissue Doppler imaging(TDI) were performed before and after therapy.The parameters include: the left atrium diameter of systolic(LAd),left atrium end-systolic volume(LAV),left ventricular eject fraction(LVEF),peak early filling(E) and late diastolic filling(A) velocity,E/A ratio,deceleration time of early filling(EDT);systolic(Sm),early diastolic(Em) and late diastolic(Am) mitral annulus motion velocity,Em/Am and E/Em ratio,statistical analysis was done.Results Clinical symptoms of HCM patients were seen alleviated significantly after Metoprolol therapy.Before the therapy,LAd,LAV,E/Em increased progressively,when Em,Em/Am decreased,EDT prolonged.After Metoprolol therapy these parameters were seen improved significantly.Conclusion Metoprolol can be an effective drug to improve cardiac function and clinical symptoms in HCM patients,TDI is a effective method for cardiac function evaluation.