组织多普勒成像技术对肥厚型心肌病心室间和右心室内心肌收缩同步运动的评价

摘要

Objective:To assess the synchrony of inter-ventricular and intra-right ventricular contraction in patients with hypertrophic cardiomyopathy( HCM)by tissue Doppler imaging(TDI).rnMethods:Our study included two groups,HCM group,n=33 patients and Control group,n =23 healthy individuals. TDI was conducted in all subjects to evaluate the time-to-peak (TTP) of systolic velocity of left ventricular wall(LVW) , inter-ventricular septum(IVS) ,right ventricular wall(RVW)at atrial-ventricular annulus level,and the TTP of RVW at basal and middle segments from apical four-chamber view. The data was analyzed and compared between two groups.rnResults: Compared with Control group, HCM patients presented delayed TTP of LVW, IVS and RVW at atrial-ventricular annulus level,and delayed TTP of RVW at basal and middle segments,P<0. 05 or P<0. 01 respectively. HCM group also showed increased differences of TTP between RVW and LVW,RVW and IVS,and increased difference of RVW between basal and middle segments,P<0. 01 or P<0. 05 respectively.rnConclusion: Our work confirmed the dyssynchrony of inter-ventricular and intra-right ventricular contraction in HCM patients.%目的:应用组织多普勒成像技术评价肥厚型心肌病(HCM)心室间和右心室内心肌收缩同步性.方法:连续观察肥厚型心肌病(HCM组)患者33例和健康志愿者(正常对照组)23例的动态组织多普勒图像,取样容积分别置于心尖四腔心切面房室瓣水平的左心室游离壁、室间隔、右心室游离壁,以及右心室游离壁基底段、中间段,测量从QRS波起始点到收缩期峰值的时间,并对两组结果进行分析.结果:HCM组与正常对照组比较,达峰时间在左心室游离壁、室间隔、右心室游离壁、右心室游离壁中间段及基底段均显著延迟,差异均有统计学意义(P＜0.05或P＜0.01)；右心室游离壁与左心室游离壁达峰时间的差值、右心室游离壁与室间隔达峰时间的差值、室间隔与左心室游离壁达峰时间的差值、右心室游离壁基底段与中间段达峰时间的差值均显著增加,差异均有统计学意义(P＜0.05或P＜0.01).结论:HCM患者存在心室间和右心室内心肌收缩不同步性.