Vizzardi E, Sciatti E, Bonadei I, Gelsomino S, Lorusso R, Metra M
Section of Cardiovascular Diseases, Department of Medical and Surgical Specialties, Radiological Sciences and Public Health, University of Study of Brescia, Brescia, Italy.
Eur Rev Med Pharmacol Sci. 2014;18(21):3251-5.
Previous studies revealed that hypertrophic cardiomyopathy (HCM) patients have impaired aortic elastic properties with contrasting data about aortic dimensions. We aimed to extend our knowledge about this topic, considering tissue Doppler imaging (TDI) and tissue strain.
25 HCM patients and 25 healthy volunteers matched for age and sex were enrolled. They underwent transthoracic echocardiography to measure aortic dimensions at four levels (Valsalva sinuses, sinotubular junction, tubular tract, aortic arch), elastic properties (i.e., distensibility, stiffness, M-mode strain, tissue strain), and TDI aortic wall velocities (S', E', A' waves).
Aortic dimensions differed between the two groups only at sinotubular junction (18 ± 6 vs. 15 ± 3 mm/m2; p = 0.039) and aortic arch levels (19 ± 5 vs. 11 ± 8 mm/m2; p < 0.001). Aortic stiffness was significantly higher among patients (16.4 ± 23.2 vs. 5.9 ± 3.4; p = 0.034), and TDI waves greater (S': 5.2 ± 1.9 vs. 8.0 ± 2.7 cm/s, p < 0.001; E': -5.3 ± 2.4 vs. -7.2 ± 2.7 cm/s, p = 0.012; A': -5.3 ± 1.6 vs. -8.6 ± 4.5 cm/s, p = 0.002). M-mode and tissue strains, and aortic distensibility did not reach statistical significance, although showing a tendency to altered values in the HCM group.
Patients affected by HCM show a larger aorta and altered aortic elastic properties compared with healthy volunteers. These findings could help to investigate treatment response and prognosis of these alterations.
既往研究显示肥厚型心肌病(HCM)患者的主动脉弹性特性受损,关于主动脉尺寸的数据存在差异。我们旨在通过组织多普勒成像(TDI)和组织应变来扩展对此主题的认识。
纳入25例年龄和性别相匹配的HCM患者及25名健康志愿者。他们接受经胸超声心动图检查,以测量主动脉四个水平(主动脉窦、窦管交界、管状段、主动脉弓)的尺寸、弹性特性(即扩张性、硬度、M型应变、组织应变)以及TDI主动脉壁速度(S'、E'、A'波)。
两组之间仅在窦管交界水平(18±6 vs. 15±3 mm/m2;p = 0.039)和主动脉弓水平(19±5 vs. 11±8 mm/m2;p < 0.001)的主动脉尺寸存在差异。患者的主动脉硬度显著更高(16.4±23.2 vs. 5.9±3.4;p = 0.034),TDI波更大(S':5.2±1.9 vs. 8.0±2.7 cm/s,p < 0.001;E':-5.3±2.4 vs. -7.2±2.7 cm/s,p = 0.012;A':-5.3±1.6 vs. -8.6±4.5 cm/s,p = 0.002)。M型和组织应变以及主动脉扩张性虽未达到统计学意义,但HCM组显示出值改变的趋势。
与健康志愿者相比,HCM患者的主动脉更大且主动脉弹性特性改变。这些发现有助于研究这些改变的治疗反应和预后。