超声心动图联合心脏MRI评价心肌纤维化对肥厚型心肌病患者左心室功能的影响  

Echocardiography combined with cardiac magnetic resonance imaging to evaluate the influence of myocardial fibrosis on left ventricular function in patients with hypertrophic cardiomyopathy

作　　者：周晨晖 戴丽雅 周宁[1] 赖小伟[1] 陈方红[1] ZHOU Chenhui;DAI Liya;ZHOU Ning(Department of Ultrasound,Lishui Center Hospital,Lishui 323000,China)

机构地区：[1]丽水市中心医院超声科,323000

出　　处：《心电与循环》2020年第3期269-272,共4页Journal of Electrocardiology and Circulation

摘　　要：目的评价心肌纤维化对肥厚型心肌病患者左心室功能的影响。方法选择2017年1月至2019年3月就诊的62例肥厚型心肌病患者为研究对象,均行MRI和超声心动图检查。根据MRI检查结果将患者分为心肌纤维化组(34例)和无心肌纤维化组(28例),分析比较两组的超声心动图参数。结果心肌纤维化组的左心房前后径、室间隔厚度、室壁最厚处厚度、左心房最大容积指数、室间隔二尖瓣舒张早期速度峰值/舒张早期运动峰值(E/e')、侧壁E/e'、平均E/e'、三尖瓣口反流最大流速、等容舒张时间及肺静脉心房逆向流速均明显大于无心肌纤维化组,差异均有统计学意义(P<0.05或0.01)。两组患者左心室舒张末期内径、左心室后壁厚度、左心室射血分数比较,差异无统计学意义(均P>0.05)。结论心肌纤维化加重肥厚型心肌病左心室舒张功能障碍。Objective To evaluate the influence of myocardial fibrosis on left ventricular(LV)function in patients with hypertrophic cardiomyopathy(HCM).Methods 62 patients with HCM were enrolled from January 2017 to March 2019.All patients underwent cardiac magnetic resonance imaging(MRI)and echocardiography examination.They were divided into myocardial fibrosis group(34 cases)and non-myocardial fibrosis group(28 cases)based on MRI results.The echocardiographic parameters were analyzed and compared between the two groups.Results Left atrial(LA)diameter,interventricular septal thickness,maximal wall thickness,maximal LA volume index,interventricular septum E/e',lateral wall E/e',mean E/e',maximal tricuspid regurgitation,isovolumic relaxation time,and atrial reverse flow velocities in the pulmonary vein were significantly greater in myocardial fibrosis group than in non-myocardial fibrosis group(P<0.05 or 0.01).LV end diastolic diameter,LV posterior wall thickness and LV ejection fraction were no different between the two groups(all P>0.05).Conclusion Myocardial fibrosis may aggravate left ventricular diastolic dysfunction in patients with HCM.

关 键 词：心肌纤维化 肥厚型心肌病 超声心动图 心脏MRI 

分 类 号：R542.2[医药卫生—心血管疾病]