Butz T, van Buuren F, Mellwig K-P, Langer C, Oldenburg O, Treusch K A, Meissner A, Plehn G, Trappe H-J, Horstkotte D, Faber L
Medizinische Klinik II (Kardiologie und Angiologie), Marienhospital Herne, Klinikum der Ruhr-Universität Bochum, Herne.
Ultraschall Med. 2012 Oct;33(5):455-62. doi: 10.1055/s-0029-1246069. Epub 2011 Feb 3.
Echocardiographic Tissue Doppler Imaging (TDI) has been proposed for the differentiation of pathological left ventricular hypertrophy (e. g. hypertrophic cardiomyopathy, HCM) and physiologic left ventricular hypertrophy (athlete's heart). The aim of this study was the TDI analysis of the systolic (S') and early diastolic (E') velocities in patients (pts.) with non-obstructive hypertrophic cardiomyopathy (HCM) and in top-level athletes in consideration of the previously published cut-off values (S' < 9 cm/s, E' < 9 cm/s).
Pulsed-wave TDI of the systolic and early-diastolic velocities was performed at the lateral and septal mitral annulus in the four-chamber view in 17 HCM pts (12 men; mean age 44 ± 16 years) and 80 consecutive athletes (80 men; mean age 26 ± 5 years).
Pts with HCM showed significantly decreased systolic velocities of the septal (S' septal: 5.1 ± 1.2 cm/s versus 9.5 ± 1.5 cm/s, p < 0.001) and lateral mitral annulus (S' lateral: 6.4 ± 2.0 cm/s vs. 10.5 ± 2.1 cm/s, p < 0.001). The early diastolic velocity of the mitral annulus E' was significantly decreased in HCM, too (E' septal: 5.9 ± 2.2 cm/s vs. 13.1 ± 2.9 cm/s, p < 0.001; E' lateral: 8.2 ± 3.0 cm/s vs. 16.5 ± 3.4 cm/s, p < 0.001).
Tissue Doppler Imaging of the systolic and early diastolic velocity of the mitral annulus might be helpful as a promising additional method for the echocardiographic differentiation between pathological and physiologic left ventricular hypertrophy.
超声心动图组织多普勒成像(TDI)已被用于鉴别病理性左心室肥厚(如肥厚型心肌病,HCM)和生理性左心室肥厚(运动员心脏)。本研究的目的是根据先前公布的截断值(S'<9 cm/s,E'<9 cm/s),对非梗阻性肥厚型心肌病(HCM)患者和顶级运动员的收缩期(S')和舒张早期(E')速度进行TDI分析。
对17例HCM患者(12例男性;平均年龄44±16岁)和80例连续入选的运动员(80例男性;平均年龄26±5岁)在四腔心切面二尖瓣环的侧壁和间隔处进行收缩期和舒张早期速度的脉冲波TDI检查。
HCM患者二尖瓣环间隔处的收缩期速度(S'间隔:5.1±1.2 cm/s对9.5±1.5 cm/s,p<0.001)和侧壁的收缩期速度(S'侧壁:6.4±2.0 cm/s对10.5±2.1 cm/s,p<0.001)显著降低。二尖瓣环E'的舒张早期速度在HCM患者中也显著降低(E'间隔:5.9±2.2 cm/s对13.1±2.9 cm/s,p<0.001;E'侧壁:8.2±3.0 cm/s对16.5±3.4 cm/s,p<0.001)。
二尖瓣环收缩期和舒张早期速度的组织多普勒成像可能有助于作为一种有前景的辅助方法,用于超声心动图鉴别病理性和生理性左心室肥厚。