Manyari D E, Paulsen W, Boughner D R, Purves P, Kostuk W J
Am Heart J. 1983 Jun;105(6):980-7. doi: 10.1016/0002-8703(83)90400-3.
Left ventricular ejection fraction (EF) at rest and during exercise was measured in 19 patients with hypertrophic cardiomyopathy (HCM) by means of radionuclide angiography. The results were compared to those in 20 normal subjects. Based on hemodynamic data, patients with HCM were divided into three groups. In group I, no demonstrable left ventricular outflow obstruction, there were five patients; their mean EF increased from 68% +/- 8.9 (+/- SD) at rest to 74% +/- 9.2 during exercise (p less than 0.05). In group II, latent obstruction, there were six patients; their mean EF at rest (75.2% +/- 8.2) and at peak exercise (78.7% +/- 6.7) was not statistically different (p greater than 0.05). Group III, obstruction present at rest, consisted of eight patients; EF at rest (82.6% +/- 8.5) decreased significantly during exercise (75.6% +/- 7.7, p less than 0.01). In normal subjects resting EF was 66.3% +/- 7.6; it increased to 76.4% +/- 7 (p less than 0.001). Exercise duration and heart rate-blood pressure product were lower in groups II and III. Thus there are significant differences in left ventricular systolic function both at rest and during exercise between these three major hemodynamic subgroups. These findings emphasize the importance of such a hemodynamic classification of HCM.
采用放射性核素血管造影术对19例肥厚型心肌病（HCM）患者静息和运动时的左心室射血分数（EF）进行了测量。将结果与20名正常受试者的结果进行了比较。根据血流动力学数据，将HCM患者分为三组。第一组，无明显左心室流出道梗阻，有5例患者；他们的平均EF从静息时的68%±8.9（±标准差）增加到运动时的74%±9.2（p<0.05）。第二组，潜在梗阻，有6例患者；他们静息时的平均EF（75.2%±8.2）和运动峰值时的平均EF（78.7%±6.7）无统计学差异（p>0.05）。第三组，静息时存在梗阻，由8例患者组成；静息时的EF（82.6%±8.5）在运动时显著降低（75.6%±7.7，p<0.01）。正常受试者静息时的EF为66.3%±7.6；运动时增加到76.4%±7（p<0.001）。第二组和第三组的运动持续时间和心率-血压乘积较低。因此，这三个主要血流动力学亚组在静息和运动时的左心室收缩功能存在显著差异。这些发现强调了HCM这种血流动力学分类的重要性。
