Asín Cardiel E, Moya Mur J L
Servicio de Cardiología, Hospital Ramón y Cajal, Madrid.
Rev Esp Cardiol. 1996 Feb;49(2):136-45.
Hypertrophic cardiomiopathy is a peculiar process with different anatomical and functional abnormalities which are present in different degrees in each case. Echocardiography and Doppler techniques have contributed definitively to the knowledge of this process and these procedures are choices for establishing the diagnosis of hypertrophic cardiomyopathy and to evaluate the clinical and morphological diversity of this process consisting of a spectrum of abnormalities with a variable presence in each case. Disproportionate septal hypertrophy is the most frecuent finding but the hypertrophy can involve other segments and different patterns can be present; concentric hypertrophy, apical, involving right ventricle, inverted asymetric, etc. Anterior mitral valve motion can be produced by the interrelation between anatomic factors of the valve, geometry of the outflow tract and physical forces produced by flow changes. Doppler echocardiography allows us to evaluate subaortic obstruction, to define its site, to demonstrate and measure the degree of mitral regurgitation and to carry out intraoperative studies. In hypertrophy cardiomyopathy the pattern of delayed relaxation is the most frequent but patients with severe obstruction and mitral regurgitation can pseudonormalize this pattern and even show restrictive patterns.
肥厚型心肌病是一个独特的过程，伴有不同的解剖和功能异常，每种情况的异常程度各不相同。超声心动图和多普勒技术对了解这一过程起到了决定性作用，这些检查方法是诊断肥厚型心肌病以及评估该过程临床和形态学多样性的选择，该过程由一系列异常组成，每种情况中这些异常的存在情况各不相同。不对称性室间隔肥厚是最常见的表现，但肥厚也可累及其他节段，且可呈现不同模式；如向心性肥厚、心尖肥厚、累及右心室、反向不对称肥厚等。二尖瓣前叶运动可由瓣膜的解剖因素、流出道几何形态以及血流变化产生的物理力之间的相互关系引起。多普勒超声心动图可让我们评估主动脉瓣下梗阻情况、确定其部位、显示并测量二尖瓣反流程度以及进行术中研究。在肥厚型心肌病中，延迟松弛模式最为常见，但严重梗阻和二尖瓣反流的患者可能使这种模式假性正常化，甚至表现为限制性模式。
