应变率显像对肥厚型心肌病心肌收缩和舒张功能的研究

目的　通过应变率显像评价肥厚型心肌病患者肥厚心肌的局部收缩和舒张功能。方法　10例肥厚型心肌病患者(HCM)与 20例正常对照者,获取左室室间隔长轴方向基底段、中段和心尖段的心肌应变率曲线,及中段肥厚的室间隔三层心肌的应变率曲线,测定应变率数值 (SR),包括收缩期峰值SR、舒张早期峰值SR和舒张晚期峰值SR,测量左室射血分数(EF)和二尖瓣口血流的E、A峰值。结果　HCM组肥厚节段心肌收缩期和舒张期的SR均低于正常组相应节段的测值(P<0. 05)。HCM组肥厚节段内层、中层及外层心肌收缩期和舒张期的SR均低于正常组对应节段各层的相应测值(P<0. 05)。HCM组肥厚节段各层心肌收缩期和舒张期SR之间的差异无显著性意义。两组间的EF和E/A值差异无显著性意义。结论　肥厚型心肌病肥厚心肌的SR明显降低,其各层之间SR的差异无显著性意义。

Study on systolic and diastolic function by myocardial strain rate imaging in patients with hypertrophic cardiomyopathy

Objective To evaluate the systolic and diastolic function in hypertrophic segments by myocardial strain rate imaging in the patients with hypertrophic cardiomyopathy (HCM).Methods Ten patients with HCM in the mid segment of the ventricular septum and 20 age-matched healthy controls were included.The myocardial strain rate (SR) curves in bas,mid and apical segments were respectively acquired on the left ventricular septum longitudinal axis position for all the participants,and the SR curves of endocardial,mid-myocardial,epicardial layers in mid segment were also acquired.The SR values including the peak systolic SR,the peak early-diastolic SR,the peak late-diastolic SR were respectively measured,the left ventricular eject fraction (EF) and the Doppler transmitral filling velocities (E and A values) were also measured.Results SR values measured from the hypertrophic segments were significantly lower than those from the corresponding segments of the septum in control group (P<(0.05)).SR values from the three layers of the septal hypertrophic segments in HCM patients were significantly lower than those recorded from the corresponding segments and layers in control group(P<(0.05)).As to SR,no statistical differences were shown among the three layers of the mid septal segment in HCM patients,respectively.The EF% and E/A values show no differences between two groups.Conclusions SR of the hypertrophic segment is decreased and no statistical differences are shown among its three layers.