超声心动图在评估肥厚型梗阻性心肌病患者室间隔化学消融后左心重构中的作用  

Evalutation on the remodeling of left atrium and ventricular in patients with hypertrophic obstructive cardiomyopathy after percutaneous transluminal septal myocardial ablation by echocardiography

作　　者：王淑珍[1] 熊峰[1] 冯坤[1] 唐炯[1] 

机构地区：[1]成都市第三人民医院心脏彩超室,610031

出　　处：《实用医学影像杂志》2014年第3期156-158,共3页Journal of Practical Medical Imaging

基　　金：四川省卫生厅科研基金(120538)

摘　　要：目的探讨肥厚型梗阻性心肌病（HOCM）患者经皮室间隔化学消融术（PTSMA）前后左心系统结构与功能的改变。方法对26例HOCM患者实施PTSMA，所有患者于术前1～3 d及术后6个月接受超声心动图检查。超声测量参数：舒张末期室间隔厚度（IVSd）及左室后壁厚度（LVPWd）、左室舒张末期内径（LVEDd）、收缩末期左房内径（LAESd）、左室舒张末期容积（LVEDV）、收缩末期容积（LVESV）、左室射血分数（LVEF）、左室质量（LVM）及左心室流出道压力差（LVOTG）。结果与术前相比，术后患者室间隔厚度变薄、左室质量明显下降；左房内径变小、左室流出道压差明显下降；同时，患者流出道压差变化值（驻LVOTG）与左室质量变化值（驻LVM）间无明显相关性，但是流出道压差变化值（驻LVOTG）与室间隔厚度变化值（驻IVSd）及左房内径变化值（驻LAESd）间有良好的相关性。结论超声心动图是评估HOCM患者PTSMA术后左心结构与功能重构的一种有效方法。Objective To evaluate the changes in structure and function of left atrium（LA） and left ventricular （LV） in patients with hypertrophic obstructive cardiomyopathy （HOCM） before and after percutaneous transluminal septal myocardial ablation （PTSMA）. Methods PTSMA was performed in 26 patients with HOCM. All patients re-ceived echocardiography examination 1-3 days before and 6 months after PTSMA. By echocardiography, the end-dias-tolical thicknesses of the left ventricular posterior wall （LVPWd） and IVSd were measured, as well as the dimensions of the left atrium （LAESd）and the left ventricular （LVEDd）. The LV end-diastolic and end-systolic volumes （LVEDV and LVESV） and ejection fraction（LVEF）were calculated using a modified Simpson′s biplane method in the apical 4-and 2-chamber views. LV mass was calculated by a validated anatomic formula. Peak LVOT pressure gradient was es-timated by means of the simplified Bernoulli equation. Results After the procedure,there were significant reductions on IVSd,LVM,LAESd and LVOTG while there was no significant correlation between changes of LV mass and the changes of LVOTG （△LVOTG）, however,the changes of LVOTG correlated well with the changes of IVSd, and the changes of LAESd. Conclusion Echocardiography is a reliable method for evaluating the remolding of left atrium and left ventricular in patients with HOCM during PTSMA .

关 键 词：超声心动描记术 心肌病 肥厚型 导管消融术 心室重构 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]