肥厚性心肌病的心室造影特点  

Morphological characteristics of left ventriculography in patients with hypertrophic cardiomyopathy

作　　者：何晨[1] 袁晋青[1] 杨跃进[1] 陈珏[1] 尤士杰[1] 吴元[1] 李健军[1] 刘海波[1] 吴永建[1] 姚民[1] 秦学文[1] 乔树宾[1] 高润霖[1] 陈纪林[1] 

机构地区：[1]北京协和医学院中国医学科学院心血管病研究所阜外心血管病医院冠心病诊疗中心,北京市100037

出　　处：《中华老年多器官疾病杂志》2010年第5期414-416,共3页Chinese Journal of Multiple Organ Diseases in the Elderly

摘　　要：目的分析梗阻型肥厚性心肌病（HOCM）患者心室造影结果及形态学特征。方法纳入1995~2005年收治入院并接受心室造影和超声检查的74例确诊为肥厚型心肌病的患者。以左心室流出道与左心室压力差≥30 mmHg为梗阻型,〈30 mmHg为非梗阻型,将患者分为2组。比较其形态学和造影结果。结果 （1）入选74例患者,梗阻型14例（18.9%）,其中收缩期前向运动6例（42.9%）,冠心病3例（21.4%）;非梗阻型60例（81.1%）,其中11例合并冠心病（18.3%）。（2）超声显示室间隔增厚至（11.4±2.5）mm,左室后壁厚度（9.8±1.7）mm,左心室舒张末内径（48±5）mm,左心房内径（36±5）mm。（3）左室造影显示左室舒张末容积为（123±31）ml,左室收缩末容积为（27±11）ml,左心室射血分数（EF）为（78±6）%。（4）左心室造影形态学特征为梗阻型心室结构14例,其中正常5例;非梗阻型左心室结构60例,正常27例。结论非梗阻型肥厚性心肌病与HOCM左室舒张末内径、左室舒张末容积及左室收缩末容积、EF值,以及呈现正常形态的病例数等均无差异。Objective To determine the morphological characteristics of hypertrophic obstructive cardiomyopathy（HOCM） patients by left ventriculography.Methods A total of 74 patients with hypertrophic cardiomyopathy（HCM）,who got a definite diagnosis by ventriculography and ultrasonography,were enrolled.The patients with left ventricular outflow tract pressure gradient ≥ 30 mmHg was categorized as HOCM group,those ≤30 mmHg as hypertrophic nonobstructive cardiomyopathy（HNCM） group.The morphological characteristics and ventriculographic results were compared between the two groups.Results（1） In 74 patients,there were 14 cases（18.9%） of HOCM（6 cases of systolic anterior motion,3 cases of coronary heart disease） and 60 cases（81.1%） of HNCM（11 cases complicated by coronary heart disease）.（2） Ultrasonography showed that left ventricular（LV） septal wall thickness was（11.4±2.5） mm,posterior wall thickness（9.8±1.7） mm,LV end-diastolic inner diameter（LVEDD）（48±5） mm,left atrial（LA） anterior posterior diameter（36±5） mm.（3） Left ventriculography demonstrated that LV end-diastolic volume（LVEDV） was（123±31） ml,LV end-systolic volume（LVESV）（27±11） ml,LV ejection fraction（LVEF）（78±6）%.（4） According to morphological characteristics revealed by left ventriculography,there were 14 cases of HOCM,including 5 cases with normal LV structure,and 60 cases of HNCM,including 27 cases with normal LV structure.Conclusion There is no significant difference between HNCM and HOCM groups in LVEDD,LVEDV,LVESV,LVEF,and number of cases with normal LV morphological characteristics.

关 键 词：梗阻型肥厚性心肌病 非梗阻型肥厚性心肌病 左室造影 

分 类 号：R542.2[医药卫生—心血管疾病]