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肥厚型心肌病和心肌梗死的左心室舒张期充盈模式:脉冲多普勒超声心动图和多门控心血池扫描研究

[Left ventricular diastolic filling patterns in hypertrophic cardiomyopathy and myocardial infarction: studies by pulsed doppler echocardiography and multi-gated blood pool scans].

作者信息

Ohkushi H, Asai M, Ishimoto T, Tominaga T, Fukuda N, Taoka M, Kusaka Y, Irahara K, Oki T, Niki T

出版信息

J Cardiogr. 1984 Jun;14(1):95-104.

PMID:6542928
Abstract

Relationship between various parameters of the left ventricular inflow velocity patterns by pulsed Doppler echocardiography and the early diastolic mean filling rate (V1) by multi-gated blood pool scans was evaluated. The materials consist of 26 patients with hypertrophic cardiomyopathy (HCM), 24 with old myocardial infarction (MI), seven with hypertensive heart disease (HHD), seven with dilated cardiomyopathy (DCM), seven with ischemic heart disease (IHD), and 16 normal subjects (N). The results were as follows: 1. Acceleration time (AT) and deceleration time (DT) were significantly prolonged in HCM (120 +/- 20 msec, 147 +/- 23 msec), MI (102 +/- 17 msec, 124 +/- 21 msec), HHD (105 +/- 11 msec, 141 +/- 17 msec) and IHD (111 +/- 16 msec, 122 +/- 20 msec) compared with those of normals (89 +/- 20 msec, 106 +/- 18 msec). 2. V1 was significantly decreased in HCM (1.14 +/- 0.28 sec-1), MI (0.68 +/- 0.24 sec-1), HHD (0.73 +/- 0.12 sec-1), DCM (0.67 +/- 0.30 sec-1) and IHD (1.03 +/- 0.29 sec-1) compared with that of normals (1.48 +/- 0.28 sec-1). 3. There were significant negative correlations between V1 and AT or DT in HCM, IHD with slightly impaired diastolic filling and normals. However, there were significant positive correlations between V1 and AT or DT in MI and DCM. These findings suggested that left ventricular diastolic filling is impaired in both HCM and MI, and that DT-V1 relationship is useful for differentiating HCM characterized by the "chamber stiffness" from MI characterized by the "myocardial stiffness".

摘要

通过脉冲多普勒超声心动图评估左心室流入速度模式的各种参数与多门控血池扫描测得的舒张早期平均充盈率(V1)之间的关系。研究对象包括26例肥厚型心肌病(HCM)患者、24例陈旧性心肌梗死(MI)患者、7例高血压性心脏病(HHD)患者、7例扩张型心肌病(DCM)患者、7例缺血性心脏病(IHD)患者以及16例正常受试者(N)。结果如下:1. 与正常受试者(89±20毫秒,106±18毫秒)相比,HCM(120±20毫秒,147±23毫秒)、MI(102±17毫秒,124±21毫秒)、HHD(105±11毫秒,141±17毫秒)和IHD(111±16毫秒,122±20毫秒)的加速时间(AT)和减速时间(DT)显著延长。2. 与正常受试者(1.48±0.28秒-1)相比,HCM(1.14±0.28秒-1)、MI(0.68±0.24秒-1)、HHD(0.73±0.12秒-1)、DCM(0.67±0.30秒-1)和IHD(1.03±0.29秒-1)的V1显著降低。3. 在舒张期充盈轻度受损的HCM、IHD以及正常受试者中,V1与AT或DT之间存在显著负相关。然而,在MI和DCM中,V1与AT或DT之间存在显著正相关。这些发现表明,HCM和MI的左心室舒张期充盈均受损,并且DT-V1关系有助于区分以“心室僵硬度”为特征的HCM和以“心肌僵硬度”为特征的MI。

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