超声心动图评价肥厚型心肌病和高血压左心室肥厚患者左心房收缩功能

目的 探讨超声心动图评价肥厚型心肌病(HCM)患者和高血压左室肥厚(HLVH)患者左房收缩功能的临床应用价值.方法 HCM患者、HLVH患者和健康体检者各30例.常规测量左房内径、室间隔厚度、左室后壁厚度及二尖瓣E、A峰,计算左房缩短分数(LAFS).分别采集各受试者的心尖二腔、心尖四腔和心尖左室长轴观动态组织速度图像,获得应变率曲线测量左房峰值应变率(LASRa),计算平均LASRa(mLASRa).结果 与对照组比较,HCM组和HLVH组LAFS和mLASRa增高,差异均有统计学意义(P＜0.05).与HLVH组比较,HCM组LAFS和mLASRa增高,差异均有统计学意义(P＜0.05).HCM组与HLVH组的mLASRa与LAFS均呈显著正相关(r=0.81,0.88;均P＜0.01).结论 超声心动图能够发现HCM患者和HLVH患者左房收缩功能改变,表现为辅泵功能增加.

Evaluation of left atrial systolic function in patients with hypertrophic cardiomyopathy or hypertensive left ventricular hypertrophy by echocardiography

Objective To explore the value of echocardiography in detecting left atrial systolic function in patients with hypertrophic cardiomyopathy(HCM) or hypertensive left ventricular hypertrophy (HLVH). Methods There were 3 groups in this study,the group of HCM, HLVH and control,each group had 30 cases. Left atrial diameter,interventricular septal thickness, posterior left ventricular thickness, peak E and A of mitralis were measured by conventional echocardiography. Left atrial fractional shortening (LAFS) was calculated. Tissue velocity imaging of all patients and controls were accepted in apical two, four and long axis chamber views. Strain rate(SR) imaging was performed on all cases, peak atrial systolic left atrial SR(LASRa) were measured at each segment (septal,lateral, posterior,anterior, and inferior walls of left atrium), mean LASRa was calculated by averaging data in all segments. Results Compared with controls, LAFS and mLASRs of HCM and HLVH were significantly higher ( P ＜0.05). Moreover, LAFS and mLASRs of HCM were significantly higher than HLVH (P ＜ 0.05). mLASRa correlated positively with LAFS of HCM and HLVH respectively ( r =0.81,0.88,all P ＜0.01). Conclusions The change of left atrial function of HCM and HLVH presented as pump function increased.