Le Vy-Van, Perez Marco V, Wheeler Matthew T, Myers Jonathan, Schnittger Ingela, Ashley Euan A
Division of Cardiovascular Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, CA 94305, USA.
Am Heart J. 2009 Sep;158(3):e27-34. doi: 10.1016/j.ahj.2009.06.006. Epub 2009 Jul 16.
To determine the relation between echocardiogram findings and exercise capacity in hypertrophic cardiomyopathy (HCM).
Sixty-three patients (48 +/- 15 years) were referred for cardiopulmonary testing and exercise echocardiography. They were classified by morphology: proximal (n = 11), reverse curvature (n = 32), apical (n = 7), and concentric HCM (n = 13). There were more women in proximal and reverse curvature groups. Proximal HCM patients were older. Maximal left ventricular thickness was highest in reverse curvature group. At peak exercise, concentric HCM achieved the lowest percent predicted maximal Vo2. Excluding apical group, no significant differences in gradient were noted between groups. Overall, no statistically significant correlation was found between peak Vo2, wall thickness, and gradient. Significant correlations were noted between peak Vo2 and indexed left atrial (LA) volume (r = -0.52), lateral E' (r = 0.50), and lateral E/E' ratio (r = -0.46). A multivariate model including age, lateral E', indexed LA volume, and mitral A wave explained 46% of the variance in peak Vo2 (P = .01).
Lateral E' and indexed LA volume are negatively correlated with functional capacity. Although patients with concentric morphology achieved the lowest peak Vo2, wall thickness and gradient did not predict exercise capacity.
确定肥厚型心肌病（HCM）患者超声心动图检查结果与运动能力之间的关系。
63例患者（48±15岁）接受了心肺功能测试和运动超声心动图检查。根据形态学将他们分为：近端型（n = 11）、反曲型（n = 32）、心尖型（n = 7）和同心型HCM（n = 13）。近端型和反曲型组女性更多。近端型HCM患者年龄更大。反曲型组的最大左心室厚度最高。在运动峰值时，同心型HCM达到的预测最大摄氧量百分比最低。排除心尖型组后，各亚组之间的压力阶差无显著差异。总体而言，峰值摄氧量、室壁厚度和压力阶差之间未发现统计学上的显著相关性。峰值摄氧量与左心房（LA）容积指数（r = -0.52）、侧壁E'（r = 0.50）和侧壁E/E'比值（r = -0.46）之间存在显著相关性。一个包含年龄、侧壁E'、LA容积指数和二尖瓣A波的多变量模型解释了峰值摄氧量46%的变异（P = .01）。
侧壁E'和LA容积指数与功能能力呈负相关。虽然同心型形态的患者达到的峰值摄氧量最低，但室壁厚度和压力阶差并不能预测运动能力。
