Department of Nuclear Medicine, Far Eastern Memorial Hospital, New Taipei City, Taiwan.
Department of Biomedical Imaging and Radiological Sciences, National Yang-Ming University, Taipei, Taiwan.
Sci Rep. 2018 Mar 8;8(1):4182. doi: 10.1038/s41598-018-22213-z.
Hypertrophic cardiomyopathy (HCM) is an often under-diagnosed cause of left ventricular hypertrophy (LVH). It affects 1/500 of the population, is the most commonly inherited cardiovascular disorder, and can present in apical, concentric, or septal forms. Although most patients are asymptomatic, sudden cardiac death can be the initial presentation of HCM. By retrospectively enrolling patients suspected of having three different types of HCM in the absence of epicardial coronary stenosis, we aimed to examine systolic and diastolic dysfunction and perfusion abnormalities using both Doppler echocardiography and state-of-the-art gated single-photon emission computerized tomography (SPECT) myocardial perfusion imaging (MPI) with a cadmium-zinc-telluride camera and thallium-201. Both regional perfusion and gated SPECT parameters were collected in addition to diastolic parameters from Doppler echocardiography. The results showed that mild ischemia was common in patients suspected of having HCM, with a mean summed stress score of 4.7 ± 4.9 (score 0-4 in 17-segment model). The patients with HCM were associated with discernible left ventricular mechanical dyssynchrony, especially those with the apical form. In addition, diastolic dysfunction was prevalent and early to late ventricular filling velocity ratios were significantly different between groups. By combining gated-MPI and Doppler data, the trivial functional changes in HCM may be identified.
肥厚型心肌病（HCM）是左心室肥厚（LVH）的一个常被漏诊的病因。它影响着 1/500 的人群，是最常见的遗传性心血管疾病，可表现为心尖型、向心型或间隔型。尽管大多数患者无症状，但肥厚型心肌病的首发表现可以是心源性猝死。通过对疑似患有三种不同类型的肥厚型心肌病但不存在心外膜冠状动脉狭窄的患者进行回顾性登记，我们旨在使用多普勒超声心动图和最先进的门控单光子发射计算机化断层扫描（SPECT）心肌灌注成像（MPI）检查收缩和舒张功能障碍以及灌注异常，这些成像均使用碲化镉锌相机和铊-201 进行。除了从多普勒超声心动图获取舒张参数外，还收集了区域性灌注和门控 SPECT 参数。结果显示，疑似患有肥厚型心肌病的患者中常见轻度缺血，平均总和应激评分 4.7±4.9（17 节段模型中评分为 0-4）。肥厚型心肌病患者存在可识别的左心室机械不同步，尤其是心尖型患者。此外，舒张功能障碍普遍存在，各组之间心室早期至晚期充盈速度比值有显著差异。通过结合门控-MPI 和多普勒数据，可识别肥厚型心肌病的微小功能性变化。
