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目的探讨肥厚型心肌病(HCM)患者右室功能变化及其与左室功能及室壁厚度的关系。方法纳入HCM单纯左室肥厚组(HCM组)23例、HCM合并右室肥厚组(HCM+RVH组)16例及健康受试者30例,分析比较三组常规超声心动图参数和应变参数,并分析右室纵向应变与左室纵向应变、室间隔及右室壁厚度的相关性。结果 HCM患者左室整体长轴应变(LV GLS)、右室整体长轴应变(RV GLS)及节段应变绝对值均明显减小,HCM+RVH组较为显著(P<0.05);HCM患者右室收缩期应变率(GRSs)绝对值、舒张早期应变率(GRSe)较对照组减小(P<0.005);HCM+RVH组舒张晚期应变率(GRSa)较对照组及HCM组减小(P<0.05);RV GLS绝对值与LV GLS绝对值呈正相关、与室间隔厚度及右室壁厚度均呈负相关(相关系数分别为0.575、-0.551、-0.364,P<0.05)。结论 HCM患者右室收缩及舒张功能均有不同程度的减低,且合并右室肥厚的患者右室功能减低更明显;HCM患者右室功能与左室功能呈正相关,与室间隔厚度、右室壁厚度呈负相关。
Objective To investigate the changes of right ventricular function in patients with hypertrophic cardiomyopathy (HCM) and its relationship with left ventricular function and wall thickness. Methods Totally 23 HCM patients, 16 HCM patients with right ventricular hypertrophy (HCM + RVH) and 30 healthy volunteers were enrolled in this study. The echocardiographic and strain parameters of three groups were compared and analyzed. The correlation between the longitudinal strain in the right ventricle and the left ventricular longitudinal strain, ventricular septum and right ventricular wall thickness was analyzed. Results LVGLS, RVGLS and absolute value of segmental strain were significantly decreased in HCM patients compared with HCM + RVH patients (P <0.05) The absolute values of systolic strain rate (GRSs) and early diastolic strain rate (GRSe) in the HCM + RVH group were significantly lower than those in the control group and the HCM group (P <0.005) <0.05). The absolute value of RV GLS was positively correlated with the absolute value of LV GLS, but negatively correlated with the thickness of interventricular septum and the thickness of right ventricle (correlation coefficients were 0.575, -0.551, -0.364, P <0.05). Conclusion Right ventricular systolic and diastolic function in patients with HCM decreased to some extent, and right ventricular dysfunction was more obvious in patients with right ventricular hypertrophy. Right ventricular function was positively correlated with left ventricular function in patients with HCM, The thickness is negatively correlated.