肥厚型梗阻性心肌病室间隔心肌消融术对二尖瓣反流的影响

目的观察经皮经冠状动脉室间隔化学消融术（PTSMA）对肥厚型梗阻性心肌病（HOCM）患者二尖瓣反流（MR）的影响。方法对28例HOCM患者实施PTSMA。所有患者于术前3天及术后6个月接受超声心动图检查，测量左心室流出道压力差（LVOTG），对二尖瓣前叶收缩期前向运动（SAM）及MR程度进行评分。结果28例HOCM患者术后6个月超声心动图测量LVOTG[（42．95士14．87）mmHg]较术前3天[（91．73±18．25）mmHg]明显下降（P〈0．01）。术后6个月SAM评分（1．32士0．81）较术前3天（2．23士0．71）明显下降（P＜0．01）。术后6个月MR评分（O．63士0．41）较术前3天（2．37士0．66）明显下降（P＜0．01）。LVOTG下降与MR减少程度呈正相关（r=0．86，P〈0．01）。结论实施PTSMA能减轻HOCM患者MR，有利于血流动力学改善。

Influence of percutaneous transluminal septal myocardial ablation of hypertrophic obstructive cardiomyopathy on mitral regurgitation

Objective To investigate the influence of percutaneous transluminal septal myocardial ablation （PTSMA） of hypertrophic obstructive cardiomyopathy （HOCM） on mitral regurgitation （MR）. Methods PTSMA was performed in 28 patients with HOCM. Left ventricular outflow-tract gradient （LVOTG）, MR grade and severity of systolic anterior motion （SAM） 3 days before and 6 months after PTSMA were measured by echocardiography. SAM of the anterior mitral valve leaflet was graded, and MR severity was assessed by color flow Doppler echocardiography. Results Six months after PTS- MA LVOTG decreased significantly from （91.73±k 18. 25） mmHg to （42.95±14.87） mmHg （P〈0.01）, mean SAM grade declined significantly from （2.23±0. 71） to （1.32±0.81） （P〈0. 01）, MR grade declined significantly from （2.37±0.66） to （0. 63±0.41） （P〈0. 01）. Decreased LVOTG positively correlated with decreased degree of MR （r=0. 86, P 〈0. 01）. Conclusion PTSMA of HOCM can decrease MR and improve hemodynamics.