超声心动图评价肥厚性心肌病升主动脉弹性的临床研究

摘要

Objective The change of ascending aortic (AAO) elasticity is an important factor in the development of cardiovascular diseases.To investigate AAO biomechanical function changes in patients with hypertrophic cardiomyopathy (HCM),the AAO elastic characteristics were evaluated by echocardiography.Methods Totally 50 HCM patients were enrolled,including 27 hypertrophic obstructive cardiomyopathy (HOCM) patients and 23 hypertrophic non-obstructive cardiomyopathy (HNOCM) patients.30 cases were set as normal control group.The end-systolic and end-diastolic AAO diameters were measured by M-mode echocardiography.The brachial blood pressure was recorded.AAO strain,distensibility and stiffness index were calculated.The systolic,early-diastolic and late-diastolic velocities of AAO anterior wall were measured by tissue Doppler imaging.The differences of parameters among three groups were compared.Results Among HOCM group,H NOCM group,and control group,the AAO strain,distensibility and early-diastolic anterior wall velocity increased sequentially (all P＜0.05),while AAO stiffness index decreased sequentially (all P＜0.01).Compared with control group,AAO anterior wall systolic velocity decreased in HOCM (P＜0.05) and late-diastolic velocity decreased in HOCM group and HNOCM group (all P＜0.05).Conclusions Compared with normal group,AAO elasticity in patients with HCM decreased,especially HOCM group decreased more obviously.%目的 升主动脉(AAO)弹性改变是心血管疾病发展过程中的一个重要因素.研究采用超声心动图评价肥厚性心肌病(HCM)患者AAO弹性特征,以期了解其生物力学功能改变.方法 连续入选HCM患者50例,其中梗阻型(HOCM) 27例、非梗阻型(HNOCM) 23例,设立健康对照组30例.采用M型超声测量AAO收缩末期及舒张末期内径,记录肱动脉血压,计算AAO应变、扩张性和僵硬度指数;采用组织多普勒方法测量AAO前壁收缩期、舒张早期及舒张晚期运动速度,比较三组间参数的差异性.结果 在HOCM组、HNOCM组和对照组间,AAO应变、扩张性及舒张早期运动速度依次增高(P均＜0.05),而AAO僵硬度指数则依次降低(P均＜0.01).HOCM组的AAO前壁收缩期运动速度低于对照组(P＜0.05);HOCM组及HNOCM组的舒张晚期运动速度低于对照组(P均＜0.05).结论 HCM患者AAO血管弹性较正常组下降,且以HOCM组下降更为显著.