Hess O M, Goebel N H, Luescher H, Schneider J, Angehrn W, Krayenbuehl H P
Eur J Cardiol. 1979 Feb;9(2):129-43.
From 1970 to 1977 the diagnosis of hypertrophic, nonobstructive cardiomyopathy was made by clinical, echocardiographic and hemodynamic findings in 13 patients (2 females and 11 males). Echocardiography showed asymmetric septal hypertrophy in 10 of the 12 evaluated patients (83%) and symmetric hypertrophy of the septum and the posterior wall in 2 patients (17%). Systolic anterior motion of the anterior mitral leaflet was found in 5 patients (42%) although there was no obstruction of the outflow tract. Significantly higher angiographic ejection parameters were present in the 13 patients with cardiomyopathy compared to 13 control patients and the angiographic lateral wall thickness was significantly larger in patients with cardiomyopathy than in controls. The clinical course was followed during 36 mth; a stable course was found in 8 (group A) and a deterioration in 5 patients (group B). Physical working capacity and left ventricular systolic ejection fraction were significantly higher in group A than in group B. Ejection fraction in group B was similar to that of the controls whereas physical working capacity was depressed. Thus, in nonobstructive cardiomyopathy a higher than normal ejection fraction is needed to maintain a normal physical working capacity. Th increased ejection performance seems, however, not to be related to an increase in muscle fiber shortening, but can be explained by geometric reasons.
1970年至1977年间，通过临床、超声心动图和血流动力学检查，对13例肥厚型非梗阻性心肌病患者（2例女性，11例男性）做出了诊断。在12例接受评估的患者中，超声心动图显示10例（83%）存在不对称性室间隔肥厚，2例（17%）存在室间隔与后壁对称性肥厚。5例患者（42%）发现二尖瓣前叶收缩期前向运动，尽管流出道并无梗阻。与13例对照患者相比，13例心肌病患者的血管造影射血参数明显更高，且心肌病患者的血管造影侧壁厚度显著大于对照组。对患者的临床病程进行了36个月的随访；发现8例患者病情稳定（A组），5例患者病情恶化（B组）。A组患者的体力工作能力和左心室收缩射血分数显著高于B组。B组的射血分数与对照组相似，但其体力工作能力下降。因此，在非梗阻性心肌病中，需要高于正常的射血分数来维持正常的体力工作能力。然而，射血能力的提高似乎与肌纤维缩短增加无关，而可以用几何原因来解释。
