Noguchi Aki, Ishizuka Naoko, Tanimoto Kyomi, Kasanuki Hiroshi
Department of Cardiology, Tokyo Women's Medical University, Kawada-cho 8-1, Shinjuku-ku, Tokyo 162-8666.
J Cardiol. 2006 Jan;47(1):15-23.
Left ventricular apical asynergy and cardiovascular complications were evaluated in patients with apical hypertrophic cardiomyopathy, in whom apical diastolic paradoxical flow toward the base could be detected by Doppler color flow echocardiography.
Twenty-nine patients with apical hypertrophic cardiomyopathy were followed up with echocardiographic examinations for at least 5 years. They were divided into three groups: those who persistently exhibited paradoxical flow (Group A, n = 13), those in whom paradoxical flow developed during the follow-up period (Group B, n = 8), and those in whom paradoxical flow was not detected during the follow-up period (Group C, n = 8). Peak flow velocity and duration of paradoxical flow, the presence or absence of apical asynergy, and cardiovascular complications were evaluated.
The mean follow-up period was 7.3 +/- 1.4 years. In Groups A and B, the apical wall motion deteriorated over time, whereas there was no asynergy change in Group C. Further, peak flow velocity and duration of paradoxical flow increased throughout the follow-up period in Groups A and B, and were correlated with the severity of apical asynergy. Ventricular tachycardia and cerebrovascular complications also occurred more often in patients with paradoxical flow.
The presence of paradoxical flow was related to the severity of apical asynergy and cardiovascular complications, and may be an important marker for evaluating the clinical course of patients with apical hypertrophic cardiomyopathy.
在经多普勒彩色血流超声心动图检测到心尖舒张期向心底矛盾血流的肥厚型心肌病患者中，评估左心室心尖部运动不协调及心血管并发症情况。
对29例肥厚型心肌病患者进行超声心动图检查随访至少5年。他们被分为三组：持续出现矛盾血流的患者（A组，n = 13），随访期间出现矛盾血流的患者（B组，n = 8），以及随访期间未检测到矛盾血流的患者（C组，n = 8）。评估矛盾血流的峰值流速和持续时间、心尖部运动不协调的有无以及心血管并发症情况。
平均随访时间为7.3±1.4年。A组和B组中心尖壁运动随时间恶化，而C组无运动不协调变化。此外，A组和B组在整个随访期间矛盾血流的峰值流速和持续时间增加，且与心尖部运动不协调的严重程度相关。矛盾血流患者发生室性心动过速和脑血管并发症也更常见。
矛盾血流的存在与心尖部运动不协调的严重程度及心血管并发症相关，可能是评估肥厚型心肌病患者临床病程的重要指标。
