心肌做功在评估非梗阻性肥厚型心肌病患者心室功能中的价值。
The value of myocardial work in assessment of ventricular function in patients with non-obstructive hypertrophic cardiomyopathy.
机构信息
Department of Cardiology, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, No.1 Dahua Road, Dongdan, Dongcheng District, Beijing, 100730, China.
Department of Gerontology, Shaanxi Provincial People's Hospital, Shaanxi Provincial Clinical Research Center for Geriatric Medicine, No.256 Youyi West Road, Xi'an, China.
出版信息
BMC Cardiovasc Disord. 2022 Jul 5;22(1):305. doi: 10.1186/s12872-022-02740-4.
BACKGROUND
To evaluate myocardial work using speckle tracking echocardiography in patients with non-obstructive hypertrophic cardiomyopathy (HCM).
METHODS
Fifty patients with HCM and 50 normal controls were included. Left ventricular ejection fraction (LVEF) was quantified using the bi-plane Simpson's method. Myocardial work parameters, which included global work index (GWI), global constructive work (GCW), global waste work (GWW), and global work efficiency (GWE), were derived from the 2D strain-pressure loop.
RESULTS
The patient group was older (49.19 ± 14.69 vs. 37.16 ± 7.49 years old) and had a higher body mass index (24.93 ± 3.67 vs. 23.26 ± 3.32 kg/m) and systolic blood pressure (121.81 ± 16.50 vs. 115.30 ± 11.01 mmHg) (P < 0.05). The mean LVEF in patients was 51%, with 54% of patients had LVEF ≤ 50%. Compared to controls, GWI (946.42 ± 360.64 vs. 1639.72 ± 204.56 mmHg%), GCW (1176.94 ± 373.23 vs. 1960.16 ± 255.72 mmHg%), and GWE (83.96 ± 7.68 vs. 95.26 ± 1.98%) were significantly decreased, while GWW (158.17 ± 82.47 vs. 79.12 ± 40.26 mmHg%) was significantly increased (P < 0.05) in the patient group. In patients, GWE showed a trend of positive correlation with LVEF (r = 0.276, P = 0.06), while GWW had a trend of negative correlation with LVEF (r = - 0.241, P = 0.09). No correlation between myocardial work and LV diastolic function or QRS duration was observed. Maximal wall thickness significantly correlated with all the myocardial work parameters.
CONCLUSIONS
Assessing myocardial work adds useful information of LV function in patients with non-obstructive HCM.
背景
利用斑点追踪超声心动图评估非梗阻性肥厚型心肌病（HCM）患者的心肌做功。
方法
纳入 50 例 HCM 患者和 50 例正常对照者。采用双平面 Simpson 法测量左心室射血分数（LVEF）。从二维应变-压力环中获得心肌做功参数，包括整体做功指数（GWI）、整体有效功（GCW）、整体无效功（GWW）和整体做功效率（GWE）。
结果
患者组年龄较大（49.19±14.69 岁 vs. 37.16±7.49 岁），体重指数（24.93±3.67 千克/平方米 vs. 23.26±3.32 千克/平方米）和收缩压（121.81±16.50 毫米汞柱 vs. 115.30±11.01 毫米汞柱）较高（均 P<0.05）。患者的平均 LVEF 为 51%，54%的患者 LVEF≤50%。与对照组相比，GWI（946.42±360.64 毫米汞柱 vs. 1639.72±204.56 毫米汞柱）、GCW（1176.94±373.23 毫米汞柱 vs. 1960.16±255.72 毫米汞柱）和 GWE（83.96±7.68 毫米汞柱 vs. 95.26±1.98%）明显降低，而 GWW（158.17±82.47 毫米汞柱 vs. 79.12±40.26 毫米汞柱）明显升高（均 P<0.05）。在患者中，GWE 与 LVEF 呈正相关趋势（r=0.276，P=0.06），而 GWW 与 LVEF 呈负相关趋势（r=-0.241，P=0.09）。心肌做功与左心室舒张功能或 QRS 持续时间无相关性。最大壁厚度与所有心肌做功参数均显著相关。
结论
评估心肌做功可提供非梗阻性 HCM 患者左心室功能的有用信息。
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