声学定量技术对肥厚型心肌病患者左室舒张功能的评价

摘要

目的：应用声学定量(AQ)技术评价肥厚型心肌病(HCM)患者的左室舒张功能。方法：17例HCM患者和13例正常人进行了AQ检测。结果：与正常组相比，HCM患者左室心搏量和峰值排空率无显著性差异(P＞0.05)，左室快速充盈容量、快速充盈分数、快速充盈期左室充盈容量与心房收缩期左室充盈容量的比值、峰值快速充盈率、峰值快速充盈率与峰值心房充盈率比值明显减低，而心房充盈分数、峰值心房充盈率明显增高(P均＜0.05～0.001)；17例HCM患者中，二尖瓣血流频谱E/A＜1者占6例，左室舒张功能异常检出率为35.29%；而以AQ技术测定的峰值快速充盈率与峰值心房充盈率比值即PRFR/PAFR＜1为标准，则左室舒张功能异常检出率为58.82%(10/17)，二者联合对左室舒张功能异常检出率为82.35%(14/17)。结论：AQ技术为定量评价HCM患者的左室舒张功能提供了新的途径。%Objective:To evaluate the left ventricular diastolic function in patients with hypertrophic cardiomyopathy(HCM)by acoustic quantification(AQ)technique.Methods：Seventeen patients with HCM and 13 control subjects were studied with AQ technique.Results:Compared with control subjects,17 patients with HCM had decreased E velocity,increased duration of mitral A and isovolumic relaxation time.There was no difference in other parameters of mitral flow pattern between the two gruops.Compared with control subjects,17 patients with HCM had decreased rapid filling volume,rapid filling fraction,rapid filling to atrial filling ratio,peak rapid filling rate and peak rapid filling rate to peak atrial filling rate ratio and increased atrial filling fraction,peak atrial filling rate on the left ventricular AQ waveform.However there were no changes in atrial filling volume and peak emptying rate between the two groups.Indeed,in the present study Doppler echocardiography identified abnormalities in 6 of 17 patients compared with those in 10 of 17 patients identified by left ventricular AQ technique.Conclusions:AQ technique may be used as a method to quantify the left ventricular diastolic function in patients with HCM.