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目的:应用多普勒组织成像技术(DTI)评价肥厚型心肌病患者(HCM)左心室局部与整体舒缩功能。方法:采用DTI技术测量HCM患者室间隔和左心室侧壁中段以及二尖瓣瓣环-室间隔和二尖瓣瓣环-侧壁交界处的收缩期、舒张早期和舒张晚期DTI速度峰值(Sm1～4、Em1～4、Am1～4),并与正常组进行比较。结果:HCM患者室间隔和侧壁中段以及二尖瓣瓣环-室间隔和二尖瓣瓣环-侧壁交界处收缩期Sm1～4与正常组相比无显著差异,但舒张早期Em1～4明显低于正常,舒张晚期Am1～4明显高于正常,Em1～4/Am1～4明显减低;在正常人中,Em1/Am1和Em2/Am2无显著性差异(P>0.05),但HCM患者Em1/Am1明显低于Em2/Am2(P<0.05),且该组患者室间隔厚度明显大于侧壁厚度(2.36±0.50)cmvs(1.20±0.23)cm,P<0.05。结论:DTI技术测量的室壁运动速度可早期而准确反映HCM患者左心室舒缩功能的变化,为左心室舒缩功能的评价提供了一种新的方法。
Objective: To evaluate the local and global left ventricular systolic and diastolic function in patients with hypertrophic cardiomyopathy (HCM) by Doppler tissue imaging (DTI). Methods: DTI was used to measure the systolic, early diastolic and diastolic DTI peak velocity in the middle of the ventricular septum and the left ventricular wall in HCM patients and at the mitral annulus-ventricular septum and mitral annulus-lateral junction ~ 4, Em1 ~ 4, Am1 ~ 4), and compared with the normal group. Results: There was no significant difference in systolic Sm1 ~ 4 between HCM patients with interventricular septum and lateral wall as well as between mitral valve annulus-ventricular septum and mitral annulus-lateral junction Am1 ~ 4 was significantly higher than normal, and Em1 ~ 4 / Am1 ~ 4 was significantly lower than normal at the late stage of diastole. There was no significant difference between Em1 / Am1 and Em2 / Am2 in normal subjects (P> 0.05) Em1 / Am1 was significantly lower than that of Em2 / Am2 (P <0.05). The thickness of interventricular septum in this group was significantly larger than that of the side wall (2.36 ± 0.50) cmvs (1.20 ± 0.23) cm, P <0.05. CONCLUSION: The wall motion velocity measured by DTI technique can reflect the change of left ventricular systolic and diastolic function in HCM patients early and accurately, which provides a new method for the evaluation of left ventricular systolic and diastolic function.