Tencate F J, Mayala A P, Vletter W B, Roelandt J
Int J Card Imaging. 1985;1(4):217-23. doi: 10.1007/BF01568669.
We studied 11 patients with hypertrophic cardiomyopathy by color Doppler echocardiography (Group I: 6 patients with outflow obstruction, and Group II: 5 patients without outflow obstruction) to assess systolic structure and function as observed by cross-sectional echocardiography in relation to the flow dynamics. The structure and function included systolic anterior motion of mitral valve (SAM), midsystolic aortic valve closure (AoC), systolic cavity obliteration and the presence and timing of mitral incompetence. Their occurrence and timing was related to presence of aortic systolic flow and presence of turbulence. While all patients in Group I had SAM and turbulence, none of the patients in Group II had SAM nor turbulence. Early mitral incompetence appearing before SAM and turbulence, occurred in all patients of Group I and in none of Group II. Midsystolic aortic valve closure was only present in Group I and blood flow was unilaterally directed so that only 60% of aortic cross-sectional area showed blood flow. We conclude that mitral incompetence in hypertrophic cardiomyopathy in early systole is common when outflow gradient is present and is independent of mitral incompetence of mid- and late systole. During SAM, turbulence in the subaortic area and mid and late mitral incompetence occurred simultaneously. The midsystolic aortic valve closure was related to the unilaterally directed blood flow through the aortic cross-sectional area.
我们通过彩色多普勒超声心动图研究了11例肥厚型心肌病患者（第一组：6例有流出道梗阻，第二组：5例无流出道梗阻），以评估经胸超声心动图观察到的收缩期结构和功能与血流动力学的关系。结构和功能包括二尖瓣收缩期前向运动（SAM）、收缩中期主动脉瓣关闭（AoC）、收缩期心室腔闭塞以及二尖瓣反流的存在和时间。它们的发生和时间与主动脉收缩期血流的存在和湍流的存在有关。虽然第一组所有患者均有SAM和湍流，但第二组患者均无SAM和湍流。在SAM和湍流之前出现的早期二尖瓣反流，出现在第一组所有患者中，而第二组均未出现。收缩中期主动脉瓣关闭仅出现在第一组，血流呈单向，因此仅60%的主动脉横截面积有血流。我们得出结论，存在流出道梯度时，肥厚型心肌病患者早期收缩期二尖瓣反流很常见，且与中晚期二尖瓣反流无关。在SAM期间，主动脉下区域的湍流与二尖瓣中晚期反流同时发生。收缩中期主动脉瓣关闭与通过主动脉横截面积的单向血流有关。
