Department of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China; Department of Radiology, The First Hospital of Lanzhou University, Lanzhou, 730000, People's Republic of China.
Department of Magnetic Resonance Imaging, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100037, People's Republic of China.
Eur J Radiol. 2020 Mar;124:108836. doi: 10.1016/j.ejrad.2020.108836. Epub 2020 Jan 14.
To investigate the incidence, mechanism, and risk factors of aortic regurgitation (AR) in patients with hypertrophic cardiomyopathy (HCM) by using echocardiography and cardiac magnetic resonance (CMR).
105 HCM patients, 52 hypertension (HTN) patients and 50 healthy controls (HC) were retrospectively recruited. HCM patients were divided into 38 with AR (HCMAR) subject and 67 without AR. The subaortic complex, D1 (the largest distance of the interventricular septum that protruded into the LVOT) and D3 (the LVOT effective width) were assessed and compared between the two groups of HCM patients.
AR was more common in HCM than in HTN and HC (36 %, 17 %, and 10 %, respectively, P = 0.001). HCM patients with AR were older (58 ± 11 vs. 45 ± 16 years, P < 0.001) and had a higher incidence of hypertension (55 % vs. 33 %, P = 0.03). D1 was greater (13.5 ± 4.4 vs. 10.6 ± 4.0 mm, P = 0.001), and D3 was shorter in the HCMAR group (10.2 ± 5.3 vs. 13.7 ± 5.9 mm, P = 0.003). Anterior mitral leaflet length and left atrial diameter were greater in HCMAR group (all P < 0.05). On multivariable logistic regression analysis, the independent risk factors of AR in HCM patients were LVOTO and age.
This study demonstrated that AR is a common comorbidity of HCM, especially in patients with LVOTO. LVOTO and age were independent risk factors of AR in HCM patient.
应用超声心动图和心脏磁共振（CMR）研究肥厚型心肌病（HCM）患者主动脉瓣反流（AR）的发生率、机制和危险因素。
回顾性招募 105 例 HCM 患者、52 例高血压（HTN）患者和 50 名健康对照者（HC）。HCM 患者分为 38 例有 AR（HCMAR）和 67 例无 AR。评估并比较两组 HCM 患者的主动脉瓣下复合体、D1（间隔突入 LVOT 的最大距离）和 D3（LVOT 有效宽度）。
HCM 中 AR 的发生率高于 HTN 和 HC（分别为 36%、17%和 10%，P = 0.001）。HCM 伴 AR 患者年龄较大（58 ± 11 岁 vs. 45 ± 16 岁，P < 0.001），高血压发生率较高（55% vs. 33%，P = 0.03）。D1 较大（13.5 ± 4.4 毫米 vs. 10.6 ± 4.0 毫米，P = 0.001），HCMAR 组 D3 较短（10.2 ± 5.3 毫米 vs. 13.7 ± 5.9 毫米，P = 0.003）。HCMAR 组前二尖瓣叶长度和左心房直径较大（均 P < 0.05）。多变量逻辑回归分析显示，HCM 患者 AR 的独立危险因素为 LVOTO 和年龄。
本研究表明，AR 是 HCM 的常见合并症，尤其是在 LVOTO 患者中。LVOTO 和年龄是 HCM 患者 AR 的独立危险因素。
