Domsik Péter, Kalapos Anita, Chadaide Számi, Sepp Róbert, Hausinger Péter, Forster Tamás, Nemes Attila
2nd Department of Medicine and Cardiology Center, Medical Faculty, Albert Szent-Györgyi Clinical Center, University of Szeged, Szeged, Hungary.
Echocardiography. 2014 Nov;31(10):1245-52. doi: 10.1111/echo.12568. Epub 2014 Mar 20.
Hypertrophic cardiomyopathy (HCM) represents a generalized myopathic process affecting both ventricular and atrial myocardium. Reduced left atrial (LA) function was demonstrated in HCM by different methods. Three-dimensional (3D) speckle tracking echocardiography (STE) has just been introduced for the evaluation of LA. This study was designed to compare 3DSTE-derived LA volumetric and strain parameters in HCM with healthy controls.
The study comprised 23 consecutive HCM patients (mean age: 48.5 ± 15.1 years, 14 men). Their results were compared to 23 age- and gender-matched healthy controls. Complete two-dimensional Doppler echocardiography and 3DSTE have been performed in all cases.
Calculated LA maximum (66.4 ± 20.4 mL vs. 36.0 ± 6.1 mL, P < 0.0001) and minimum (39.2 ± 19.1 vs. 16.0 ± 4.6 mL, P < 0.0001) volumes and LA volume before atrial contraction (53.6 ± 19.9 vs. 24.0 ± 6.2 mL, P < 0.0001) were significantly increased in HCM patients. Atrial stroke volumes respecting cardiac cycles proved to be increased, while emptying fractions were decreased in subjects with HCM. Mean global radial (-12.2 ± 6.7% vs. -19.6 ± 11.7, P < 0.05), longitudinal (26.5 ± 16.5% vs. 29.8 ± 12.1%, P < 0.05) and 3D strain (-6.1 ± 4.4% vs. -12.5 ± 10.2%, P < 0.05) proved to be significantly reduced in HCM patients as compared with matched controls.
Three-dimensional speckle tracking echocardiography allows detailed evaluation of LA (dys) function in HCM by volumetric and strain measurements.
肥厚型心肌病（HCM）是一种影响心室和心房心肌的全身性肌病过程。通过不同方法已证实HCM患者左心房（LA）功能降低。三维（3D）斑点追踪超声心动图（STE）刚刚被用于评估左心房。本研究旨在比较HCM患者与健康对照者经3DSTE得出的左心房容积和应变参数。
该研究纳入了23例连续的HCM患者（平均年龄：48.5±15.1岁，14例男性）。将他们的结果与23例年龄和性别匹配的健康对照者进行比较。所有病例均进行了完整的二维多普勒超声心动图和3DSTE检查。
HCM患者计算得出的左心房最大容积（66.4±20.4 mL对36.0±6.1 mL，P<0.0001）、最小容积（39.2±19.1对16.0±4.6 mL，P<0.0001）以及心房收缩前左心房容积（53.6±19.9对24.0±6.2 mL，P<0.0001）均显著增加。HCM患者心动周期的心房搏出量增加，而排空分数降低。与匹配的对照者相比，HCM患者的平均整体径向应变（-12.2±6.7%对-19.6±11.7，P<0.05）、纵向应变（26.5±16.5%对29.8±12.1%，P<0.05）和三维应变（-6.1±4.4%对-12.5±10.2%，P<0.0�）均显著降低。
三维斑点追踪超声心动图可通过容积和应变测量对HCM患者的左心房（功能）异常进行详细评估。
