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目的应用组织多普勒心肌速度分布图(myocardial velocity profile,MVP)对左室短轴方向局部收缩功能进行评价。方法应用MVP对15例健康志愿者、15例高血压性左室肥厚患者和11例室间隔非对称性肥厚型心肌病患者的室间隔和左室后壁短轴方向的收缩功能进行评价。结果高血压组的室间隔和左室后壁收缩期心肌速度梯度(myocardialvelocity gradient,MVG)显著低于对照组,具有统计学差异[(1.8±0.3)vs(3.6±0.4),P<0.001和(1.9±0.2)vs(5.1±1.2),P<0.001]。肥厚型心肌病组的室间隔和左室后壁收缩期MVG显著低于对照组,具有统计学差异[(1.2±0.4)vs(3.6±0.4),P<0.0001和(2.4±0.6)vs(5.1±1.2),P<0.001]。MVG的降低以肥厚型心肌病组的室间隔最为显著,肥厚型心肌病组的室间隔收缩期MVG低于高血压组,具有统计学差异[(1.2±0.4)vs(1.8±0.3),P<0.01]。高血压组、肥厚型心肌病组和对照组室间隔的MVP均呈近似线性,但肥厚型心肌病组心肌各点速度分布较对照组和高血压组明显分散。结论高血压性左室肥厚患者和肥厚型心肌病患者左室短轴方向局部收缩功能较正常人减低,MVP能精确地反映心肌短轴上各点在心动周期中的运动速度,并可计算出MVG,可作为一种准确评价左室心肌短轴方向局部收缩功能的新方法。
Objective To evaluate the local systolic function in short axis of left ventricle by tissue Doppler myocardial velocity profile (MVP). Methods MVP was used to assess the systolic function in the short axis of the interventricular septum and posterior wall of left ventricular in 15 healthy volunteers, 15 hypertensive left ventricular hypertrophy patients and 11 patients with ventricular asymmetric hypertrophic cardiomyopathy. Results The ventricular septum and systolic myocardium velocity gradient (MVG) in hypertensive group were significantly lower than those in control group [(1.8 ± 0.3) vs (3.6 ± 0.4), P <0.001 and (1.9 ± 0.2) vs (5.1 ± 1.2), P <0.001]. The MVG was significantly lower in patients with hypertrophic cardiomyopathy than those in the control group [(1.2 ± 0.4) vs (3.6 ± 0.4), P <0.0001 and (2.4 ± 0.6) vs 5.1 ± 1.2), P <0.001]. MVG decreased to hypertrophic cardiomyopathy group ventricular septum was the most significant, hypertrophic cardiomyopathy group ventricular septal MVG was lower than the hypertensive group, with a statistically significant difference [(1.2 ± 0.4) vs (1.8 ± 0.3), P <0.01]. The MVP of hypertensive group, hypertrophic cardiomyopathy group and control group were almost linear, but the distribution of myocardial velocity in hypertrophic cardiomyopathy group was significantly more dispersed than that in control group and hypertension group. Conclusions Local hypertensive left ventricular hypertrophy and hypertrophic cardiomyopathy in patients with left ventricular short axis systolic local systolic function than normal, MVP can accurately reflect the myocardial short axis in each point of the cardiac cycle in the speed of movement can be calculated MVG can be used as a new method to accurately evaluate the local systolic function in the short axis of left ventricular myocardium.