Kolev N, Lengyel M, Cserhalmi L, Romoda T
Jpn Heart J. 1984 Jul;25(4):477-86. doi: 10.1536/ihj.25.477.
Eleven patients with hypertrophic obstructive cardiomyopathy (HOCM) and 9 patients with congestive cardiomyopathy (COCM) were studied to determine the usefulness of mean normalized velocity of circumferential fiber shortening (VCFS), mean normalized velocity of circumferential fiber lengthening (VCFL) and left ventricular diastolic distensibility obtained noninvasively from combined recordings of simultaneously calibrated left apex cardiogram and M-mode echogram. Twenty-two normal subjects were similarly investigated and served as a control. In HOCM VCFS were increased (1.83 +/- 0.2 s-1 versus 1.22 +/- 0.1 s-1 for controls, p less than 0.02) and both VCFL and diastolic distensibility were decreased (VCFL: 0.50 +/- 0.1 s-1 versus 1.32 s-1 in controls, p less than 0.001; diastolic distensibility: 0.03 +/- 0.004 cm/mmHg-1 compared with 0.18 +/- 0.003 cm/mmHg-1 for controls, p less than 0.001). In COCM all investigated indexes were diminished (VCFS: 0.49 +/- 0.1 s-1 versus 1.22 +/- 0.1 s-1 for controls, p less than 0.001; VCFL: 0.70 +/- 0.1 s-1 versus 1.32 +/- 0.1 s-1 in controls, p less than 0.01 and diastolic distensibility: 0.05 +/- 0.003 cm/mmHg-1 compared with 0.18 +/- 0.003 cm/mmHg-1 for controls, p less than 0.01). The echo-apexcardiographic indexes were significantly correlated with many analogous invasive indexes. It is concluded that the value of both M-mode echocardiography and calibrated apex cardiography is enchanced by a combination of the two methods which opens the possibility of a fresh approach to the noninvasive study of cardiac performance in cardiomyopathy.
对11例肥厚性梗阻性心肌病（HOCM）患者和9例充血性心肌病（COCM）患者进行了研究，以确定通过同步校准的心尖心电图和M型超声心动图联合记录无创获得的圆周纤维缩短平均标准化速度（VCFS）、圆周纤维延长平均标准化速度（VCFL）和左心室舒张扩张性的实用性。对22名正常受试者进行了类似的研究并作为对照。在HOCM中，VCFS增加（对照组为1.83±0.2 s-1，而对照组为1.22±0.1 s-1，p<0.02），VCFL和舒张扩张性均降低（VCFL：对照组为0.50±0.1 s-1，而对照组为1.32 s-1，p<0.001；舒张扩张性：0.03±0.004 cm/mmHg-1，而对照组为0.18±0.003 cm/mmHg-1，p<0.001）。在COCM中，所有研究指标均降低（VCFS：对照组为0.49±0.1 s-1，而对照组为1.22±0.1 s-1，p<0.001；VCFL：对照组为0.70±0.1 s-1，而对照组为1.32±0.1 s-1，p<0.01；舒张扩张性：0.05±0.003 cm/mmHg-1，而对照组为0.18±0.003 cm/mmHg-1，p<0.01）。超声心动图-心尖心电图指标与许多类似的有创指标显著相关。结论是，M型超声心动图和校准心尖心电图两种方法联合使用可提高其价值，这为心肌病心脏功能的无创研究开辟了新途径。
