心脏磁共振定量评价肥厚型心肌病患者的左室舒张功能  

Quantitative assessment of left ventricular diastolic function in patients with hypertrophic cardiomyopathy by cardiac magnetic resonance

作　　者：徐刚[1] 张笑春[2] 曲小龙[1] 赵骏[2] 孟璟[1] 欧兰[2] 胡厚源[1] 

机构地区：[1]第三军医大学西南医院心血管内科,重庆400038 [2]第三军医大学西南医院放射科,重庆400038

出　　处：《第三军医大学学报》2015年第6期563-567,共5页Journal of Third Military Medical University

基　　金：中国心血管医师研究基金(2013QY06-04)~~

摘　　要：目的应用心脏磁共振(cardiac magnetic resonance,CMR)定量评价肥厚型心肌病(hypertrophic cardiomyopathy,HCM)患者的左室舒张功能。方法纳入2013年10月至2014年8月于我科确诊为HCM的患者26例作为HCM组,其中男性15例,女性11例,年龄(43.54±13.29)岁。选取我院同期体检合格的健康志愿者28例作为对照组,其中男性16例,女性12例,年龄(41.52±11.87)岁。所有研究对象均行CMR检查获取心脏结构和功能参数,并进行对比分析。同时分析HCM组左室心肌质量(left ventricular mass,LVM)与左室峰值充盈率(left ventricular peak filling rate,LVPFR)和左房大小的相关性。其中左房大小参数包括左房前后径(left atrial anteroposterior diameter,LAAPD)、左房上下径(left atrial superoinferior diameter,LASID)和左房横径(left atrial transverse diameter,LATD)。结果与对照组比较,HCM组LVM、室间隔厚度(interventricular septal thickness,IVS)、LAAPD、LASID、LATD等参数明显增大(P<0.05),LVPFR明显减小(P<0.05),而左室收缩功能参数,如左室射血分数(left ventricular ejection fraction,LVEF)、左室峰值射血率(left ventricular peak ejection rate,LVPER)等无明显差异(P>0.05)。相关性分析显示,HCM组LVM与LVPFR呈负相关(r=-0.509,P<0.05),LVM与LAAPD和LATD呈正相关(r=0.493,0.466,P<0.05),LVM与LASID没有明显的相关性(r=0.328,P>0.05)。结论 HCM患者的左室舒张功能受损明显,CMR在定量评价HCM患者的左室舒张功能中起着重要作用。HCM患者的LVM与左室舒张功能指标(LVPFR、左房大小等)密切相关。Objective To quantitatively evaluate the left ventricular diastolic function in patients with hypertrophic cardiomyopathy （HCM） by cardiac magnetic resonance （CMR）. Methods From October 2013 to August 2014, 26 HCM patients （43.54 ±13.29 year-old in average; 15 males） and 28 healthy persons （41.52 ± 11.87 year-old in average; 16 males） as control were enrolled as the HCM group and the control group, respectively. All the subjects underwent CMR examination to assess the cardiac structure and function. The correlations of left ventricular mass （LVM） with the left ventricular diastolic function parameters including left ventricular peak filling rate （LVPFR） , left atrial anteroposterior diameter （LAAPD） , left atrial superoinferior diameter （LASID） and left atrial transverse diameter （LATD） were analyzed. Results Compared with the control group, the LVM, interventricular septal thickness （IVS）, LAAPD, LASID and LATD increased significantly in the HCM group （P 〈 0. 05 ）, while the LVPFR decreased obviously （ P 〈 0. 05 ）. The systolic function parameters, such as left ventricular ejection fraction （LYEF） and left ventricular peak ejection rate （ LVPER）, showed no significant differences between the two groups （ P 〉 0. 05 ）. In the HCM group, LVM had significant negative correlation with LVPFR （ r = - 0. 509, P 〈 0. 05 ） and positive correlation with LAAPD and LATD （r = 0. 493 and 0. 466, respectively, P 〈 0. 05）. Conclusion In HCM patients, the left ventricular diastolic function is significantly impaired, and LVM is closely related to LVPFR and left atrial diameter. CMR plays an important role in quantitatively evaluating the left ventricular diastolic function in the HCM patients.

关 键 词：肥厚型心肌病 心脏磁共振 左室心肌质量 左室峰值充盈率 左房大小 

分 类 号：R331.31[医药卫生—人体生理学] R445.2[医药卫生—基础医学]