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目的:评价应变率成像定量检测肥厚型心肌病(HCM)患者左室局部与整体舒张功能的价值。方法:HCM患者33例,根据室间隔及室壁厚度分为非肥厚组(NH)、轻度肥厚组(MH)、重度肥厚组(SH);对照组31例。测量二尖瓣口血流播散速度(FPV);再获取其心尖四腔、两腔组织速度成像(TVI)图像脱机分析,测量参数:①舒张早期峰值应变(SRe);②舒张晚期峰值应变(SRa);③计算SRe/SRa。结果:与对照组比较,HCM组NH、MH、SH亚组SRe及SRs/SRe均显著降低,且NH>MH>SH;MH、SH组SRa显著降低,而NH组较对照组无显著差异,且NH>MH>SH;NH与MH组间SRe/SRa差异无统计学意义,与NH、MH组比较,SH组SRe/SRa显著减低;与对照组比较,HCM组所有室壁节段平均SRe、SRa及SRe/SRa均显著降低;HCM组所有室壁节段平均SRe及SRe/SRa与FPV呈显著正相关(分别为r=0.75和r=0.70,均为P<0.05),而SRa与FPV并无显著相关性(P>0.05)。结论:HCM患者左室局部与整体舒张功能均较正常人减低,且无论肥厚或非肥厚区域舒张功能均降低,而以肥厚节段舒张功能受损更重。
OBJECTIVE: To evaluate the value of strain rate imaging in the quantitative detection of local and global left ventricular diastolic function in patients with hypertrophic cardiomyopathy (HCM). Methods: Thirty-three patients with HCM were divided into non-hypertrophic group (NH), mild hypertrophic group (MH) and severe hypertrophic group (SH) according to ventricular septum and wall thickness. Control group consisted of 31 patients. (FPV) was measured. The apical four-chamber, two-chamber tissue velocity imaging (TVI) images were obtained and analyzed offline. The parameters of measurement were: ① early diastolic peak strain (SRe); ② late diastolic peak Strain (SRa); ③ Calculate SRe / SRa. Results: Compared with the control group, the levels of SRe and SRs / SRe in NH, MH and SH subgroups were significantly decreased in HCM group and NH> MH> SH. The SRa in MH and SH groups were significantly decreased, while those in NH group were not significantly different from those in control group And NH> MH> SH. There was no significant difference in SRe / SRa between NH and MH groups, and SRe / SRa in SH group was significantly lower than that in NH and MH groups. Compared with control group, the average SRe , SRa and SRe / SRa were significantly lower in all HCM group. The mean SRe and SRe / SRa of all wall segments in HCM group were positively correlated with FPV (r = 0.75 and r = 0.70, respectively, P <0.05) There was no significant correlation between FPV and FPV (P> 0.05). Conclusion: The left ventricular regional and global diastolic function in patients with HCM are lower than those in normal people, and the diastolic function is decreased in hypertrophic and non-hypertrophic regions, while the diastolic function in hypertrophic segments is more impaired.