【摘要】 目的 :1.应用无创伤性频谱多普勒技术研究左室非对称性肥厚型心肌病 (HCM)患者的右室舒张功能 ;2 .探讨 HCM患者右室舒张功能的可靠、准确的各项指标及其临床价值。方法 :应用彩色多普勒超声诊断仪结合标 导心电图 ,对 19例 HCM患者及 13例正常对照组人群的右室舒张功能进行研究。结果 :1.HCM患者舒张早期 E峰流速、 E峰流速积分显著降低 ,舒张早期 E峰减速时间明显延长 ,E峰减速度显著下降 ,E/A比值下降 (P<0 .0 0 1) ,舒张晚期 A峰流速、 A峰流速积分显著性增加 (P<0 .0 1) ;2 .HCM患者的等容收缩时间(ICT)、等容舒张时间 (IRT)均相对延长 ,右室射血时间 (ET)明显缩短 (P<0 .0 0 1) ,二组的 C指数之间亦存在显著性差异 (P<0 .0 0 1) ;3 .C指数与 ET、 (IRT+ICT)间有显著性相关关系 (r分别为 0 .81、 0 .66,P<0 .0 0 1) ,C指数与 IRT、 ICT、 ICT/ET间无相关关系。结论 :1.HCM患者的右室舒张功能明显减退 ,右室等容舒张时间延长、舒张早期主动松弛和快速充盈速率降低、舒张晚期右房收缩功能增强 ,在频谱多普勒超声心动图上表现为 IRT明显延长 ,E、EI、Dc、E/A和 EI/AI明显降低 ,A、AI和 Td显著增高 (P<0 .0 1～ <0 .0 0 1) ;2 .HCM患者的右室收缩功能亦受到负面影响 ,在频谱多普勒超声心动图上表现为更多还原

【Abstract】 Objective:To evaluate RV diastolic function of patients with asymmetrical hypertrophic cardiomyopathy and to investigate new parameters of RV diastolic function in patients with left asymmetrical ventricular hypertrophic cardiomyopathy systematically.Methods:The group which comprised 19 patients with HCM and a control group of 13 subjects who were proved to have normal LV function were studied by echocardiography.Results:1 E, EI, Dc, E/A and EI/AI tended to be decreased( P <0 001) and A, AI and Td tended to be increased( P <0 01)in patients with HCM.2 Both isovolumetric contraction time and isovolumetric relaxation time were significantly prolonged and ejection time was significantly shortened( P <0 001)in patients with HCM The index C([isovolumetric contraction time+isovolumetric relaxation time]/ejection time) was distinctly different between patients with HCM and normal subjects ( P <0 001).3 The index C showed significant correlation with ejection time and (isovolumetric contraction time+isovolumetric relaxation time) ( r =0 81?0 66, respectively)( P <0 001) The index C showed no significant correlation with such Doppler interval parameters as isovolumetric contraction time,isovolumetric relaxation time and (isovolumetric contraction time/ejection). Conclusions:It is concluded that the decreased right ventricular diastolic function was founded in patients with left ventricular HCM, which was mainly characterized as the prolonged right ventricular isovolumic relaxation time,shortenedd right ventricular ejection time,delayed diastolic filling and decreased diastolic distensibility Spectral Doppler echocardiography is a practical and reliable technique in the noninvasive assessment of the right ventricular diastolic dysfunction in patients with left ventricular HCM.更多还原