肥厚性心肌病患者右心室结构与功能变化的分析

目的:应用彩色多普勒组织成像(CDTI)技术探讨肥厚性心肌病(HCM)患者右心室结构与功能的变化。方法:HCM患者35例(HCM组),正常对照组30例,应用CDTI测量左、右心室腔大小,室壁厚度,心室流出道等指标,于心尖四腔切面记录舒张期血流频谱,测量右室等容舒张时间(IRT)、等容收缩时间(ICT)、右室射血时间(RVET)及Tei指数。结果:与正常对照组比较,HCM患者右室前壁厚度(4.56±0.70)mm比(5.43±0.87)mm]、室间隔厚度(8.66±2.51)mm比(20.53±3.37)mm]、左室后壁厚度(9.10±2.24)mm比(13.06±1.68)mm]均明显增加(P<0.05或<0.01),右室Tei指数(0.39±0.61)比(0.80±0.38)]显著升高(P<0.01),右室流出道、右室舒张末期内径两组间无显著差异(P>0.05)。结论:肥厚性心肌病患者中右心室解剖结构与功能均受影响;右室Tei指数可以反映右心收缩及舒张功能变化。

Analysis of changes of right ventricular structure and function in patients with hypertrophic cardiomyopathy

To explore changes of right ventricular （RV） structure and function in patients with hyper-trophic cardiomyopathy （HCM） by color Doppler tissue imaging （CDTI）. Methods： A total of 35 HCM patients were enrolled as HCM group and 30 normal subjects were regard as normal control group. Sizes of left and right ven- tricular chambers, ventricular wall thickness and ventricular outflow tract were measured by CDTI. Diastolic flow spectrum was recorded in apical four chamber view, and right ventricular isovolumic relaxation time （RVIRT）, isovolumetric contraction time （RVICT）, ejection time （RVET） and RV Tei index were measured. Results： Com- pared with normal control group, there were significant increase in right ventricular anterior wall thickness （4. 56 ±0.70） mm vs. （5.43 ± 0.87） mm], interventricular septal thickness E（8. 66 ±2.51） mm vs. （20.53 ± 3.37） mm], left ventricular posterior thickness （9.10 ± 2.24） mm vs. （13.06± 1.68） mm] and RV Tei index （0.39 ± 0.61） vs. （0.80 ± 0.38）] in HCM group, P〈0.05 or 〈0.01. There were no significant difference in right ventricular outflow tract and end-diastolic dimension between two groups （P〉0.05）. Conclusion： Right ventricular anatomical structure and function possess obviously change in patients with hypertrophic eardiomyopathy; right ventricular Tei index can reflect changes of right ventricular systolic and diastolic function.