Anwar Ashraf M, Soliman Osama I I, Geleijnse Marcel L, Michels Michelle, Vletter Wim B, Nemes Attila, ten Cate Folkert J
Thoraxcenter, Erasmus MC, Rotterdam, The Netherlands.
J Am Soc Echocardiogr. 2007 Jun;20(6):744-8. doi: 10.1016/j.echo.2006.11.017.
The study included 30 patients with hypertrophic cardiomyopathy (HCM) (obstructive and nonobstructive) and 15 control subjects. End-diastolic mitral annulus area (MAA(3D)) and mitral valve area (MVA(3D)) were measured by real-time 3-dimensional (3D) echocardiography. MVA(2D) and peak mitral inflow A wave velocity (V) were measured by 2-dimensional (2D) echocardiography. Left atrial ejection force (LA-EF) was calculated by 2D echocardiography and real-time 3D echocardiography using the formula: 0.5 x 1.06 x (MAA or MVA) x V2, where (1.06) is blood viscosity. LA-EF(2D-MVA), LA-EF(3D-MVA), LA-EF(3D-MAA), and V were significantly higher in patients with HCM than control subjects (P < .001). LA-EF(2D-MVA) and LA-EF(3D-MVA) were lower than LA-EF(3D-MAA) in HCM only (P < .001). In obstructive HCM, LA-EF(2D-MVA), LA-EF(3D-MVA), LA-EF(3D-MAA), and V were significantly higher than in nonobstructive HCM (P < .05). Left ventricular outflow tract gradient contributed independently to high LA-EF in obstructive HCM. We concluded that HCM is associated with higher LA-EF than normal, and higher in obstructive HCM than nonobstructive indicating a higher atrial workload that is reflected by LA-EF(3D-MAA).
该研究纳入了30例肥厚型心肌病（HCM）患者（梗阻性和非梗阻性）以及15名对照受试者。采用实时三维（3D）超声心动图测量舒张末期二尖瓣环面积（MAA(3D)）和二尖瓣瓣口面积（MVA(3D)）。采用二维（2D）超声心动图测量MVA(2D)和二尖瓣流入A波峰值速度（V）。使用公式：0.5×1.06×（MAA或MVA）×V2，通过2D超声心动图和实时3D超声心动图计算左心房射血力（LA-EF），其中（1.06）为血液黏度。HCM患者的LA-EF(2D-MVA)、LA-EF(3D-MVA)、LA-EF(3D-MAA)和V显著高于对照受试者（P <.001）。仅在HCM中，LA-EF(2D-MVA)和LA-EF(3D-MVA)低于LA-EF(3D-MAA)（P <.001）。在梗阻性HCM中，LA-EF(2D-MVA)、LA-EF(3D-MVA)、LA-EF(3D-MAA)和V显著高于非梗阻性HCM（P <.05）。左心室流出道压差独立导致梗阻性HCM中LA-EF升高。我们得出结论，HCM患者的LA-EF高于正常水平，且梗阻性HCM高于非梗阻性HCM，这表明LA-EF(3D-MAA)反映出心房工作量更高。
