定量组织速度成像技术对肥厚型心肌病收缩及舒张功能的评价

目的应用定量组织速度成像技术(QTVI)评价肥厚型心肌病(HCM)患者左心室长轴方向上的收缩和舒张功能。方法应用QTVI技术离线分析24例HCM患者和22例正常对照者左心室各心肌节段长轴方向上的速度曲线,测量收缩期峰值(Vs)、舒张早期峰值(Ve)和舒张晚期峰值速度(Va),并计算Ve/Va及收缩期和舒张早期心肌速度梯度(MVG)。结果HCM组收缩期和舒张早期MVG及各室壁基段、中段和部分尖段的Vs、Ve及Ve/Va均小于对照组,而Va与对照组间的差异无统计学意义;肥厚最为明显的节段(后室间隔中段)的Vs与相应侧壁节段的比值小于对照组,后室间隔中段的Vs、Ve与该节段的厚度呈负相关。结论HCM患者左心室长轴方向上的收缩及主动舒张功能受损,并同时累及肥厚及非肥厚的室壁,以肥厚的室壁最为明显。肥厚心肌的舒缩功能与心肌的厚度呈负相关。

Assessment of left ventricular regional function in hypertrophiccardiomyopathy with quantitative tissue velocity imaging

Objective To assess left ventricular systolic and diastolic functions in patients with hypertrophic cardiomyopathy (HCM) using quantitative tissue velocity imaging (QTVI). Methods Off line profiles of the left ventricular regional systolic and diastolic velocity along long axis in 24 HCM patients and 22 healthy subjects were analyzed by QTVI. Regional systolic (Vs), early diastolic (Ve) and end diastolic (Va) velocities were measured at each segment of ventricular basal, middle and apical levels, and Ve/Va ratio, myocardial velocity gradient (MVG) were calculated. Results Compared with healthy subjects, patients with HCM showed lower Vs, Ve, Ve/Va and MVG, while Va showed no statistic difference between two groups. Middle segment of posterior ventricular septum and lateral corresponding segment ratio was lower than control group. Vs and Ve of middle segment of posterior ventricular septum showed negative correlation with their thickness. Conclusion There are significant differences between regional left ventricular function of patients with HCM and healthy subjects. These differences occur in systole and diastole, more striking in the hypertrophied wall, and also occur in nonhypertrophied segments. There is a negative correlation between systolic or diastolic function and thickness in hypertrophic segment.