Crowley J J, Dardas P S, Harcombe A A, Shapiro L M
Regional Cardiac Unit, Papworth Hospital, Cambridge, United Kingdom.
Heart. 1997 Jun;77(6):558-63. doi: 10.1136/hrt.77.6.558.
To use transthoracic Doppler echocardiography to assess coronary blood flow non-invasively in patients with hypertrophic cardiomyopathy.
High frequency transthoracic Doppler echocardiography was used to assess resting phasic coronary velocity patterns in patients with hypertrophic cardiomyopathy and to define the relation between coronary flow patterns and clinical, echocardiographic, and haemodynamic manifestations of this condition.
A tertiary referral cardiothoracic centre.
Fifteen patients (10 men and five women, mean (SD) age 49 (10.3) years) with asymmetric hypertrophic cardiomyopathy underwent high frequency (5 MHz) transthoracic Doppler echocardiographic assessment of the left anterior descending coronary artery. In addition, standard two dimensional echocardiography was performed. The results were compared with 16 normal participants (nine men and seven women, mean age 61.2 (10.7) years) who had no evidence of cardiac disease.
Biphasic diastolic predominant coronary artery blood velocity profiles were obtained in all patients and controls. Systolic peak blood velocity and velocity time integral were significantly reduced in the hypertrophic cardiomyopathy group compared with controls (11.3 (15.8) cm/s and 1.09 (1.78) cm v 20.5 (13.1) cm/s and 4.23 (2.80) cm, respectively, P < 0.05). A reversed pattern of systolic blood flow velocity was found in three patients with severe anterior wall and septal hypertrophy. During diastole there was prolongation of the diastolic acceleration (203 (53) ms v 110 (60) ms in controls, P < 0.05) and deceleration times (487 (200) ms v 210 (90) ms in controls, P < 0.05). There was no significant difference between those with and without symptoms or a left ventricular outflow tract gradient.
Patients with hypertrophic cardiomyopathy have abnormal systolic and diastolic coronary flow profiles at rest when measured by transthoracic echocardiography.
运用经胸多普勒超声心动图对肥厚型心肌病患者的冠状动脉血流进行无创评估。
采用高频经胸多普勒超声心动图评估肥厚型心肌病患者静息时的阶段性冠状动脉血流速度模式，并确定冠状动脉血流模式与该疾病的临床、超声心动图及血流动力学表现之间的关系。
一家三级转诊心胸中心。
15例（10例男性和5例女性，平均（标准差）年龄49（10.3）岁）非对称性肥厚型心肌病患者接受了高频（5兆赫）经胸多普勒超声心动图对左前降支冠状动脉的评估。此外，还进行了标准二维超声心动图检查。将结果与16名无心脏病证据的正常参与者（9例男性和7例女性，平均年龄61.2（10.7）岁）进行比较。
所有患者和对照组均获得双相舒张期为主的冠状动脉血流速度曲线。与对照组相比，肥厚型心肌病组的收缩期峰值血流速度和速度时间积分显著降低（分别为11.3（15.8）厘米/秒和1.09（1.78）厘米，而对照组为20.5（13.1）厘米/秒和4.23（2.80）厘米，P<0.05）。3例严重前壁和室间隔肥厚患者出现收缩期血流速度反向模式。舒张期，舒张期加速时间延长（对照组为110（60）毫秒，患者组为203（53）毫秒，P<0.05），减速时间延长（对照组为210（90）毫秒，患者组为487（200）毫秒，P<0.05）。有症状和无症状或有左心室流出道压差的患者之间无显著差异。
经胸超声心动图测量时，肥厚型心肌病患者静息时的收缩期和舒张期冠状动脉血流模式异常。
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