Echocardiographic Assessment of Left Ventricular Filling and Septal and Posterior Wall Dynamics in Idiopathic Hypertrophic Subaortic Stenosis
Echocardiographic Assessment of Left Ventricular Filling and Septal and Posterior Wall Dynamics in Idiopathic Hypertrophic Subaortic Stenosis
复制标题
超声心动图评估特发性肥厚性主动脉瓣下狭窄的左心室充盈以及室间隔和后壁动力学
作者：
M. Sutton;A. Tajik;D. Gibson;D. Brown;J. Seward;E. R. Giuliani
为了研究特发性肥厚性主动脉瓣下狭窄（IHSS）患者的左心室功能，应用计算机分析了IHSS患者左心室超声心动图，并与正常人进行了比较。即使存在严重的舒张异常，收缩功能也始终正常或高于正常。IHSS中舒张功能的广泛变化允许根据左心室峰值充盈率将患者分为三组。由于严重的室间隔肥大和运动功能减退，左室充盈峰值率主要由游离壁变薄的速率决定。第1组患者左室充盈速度较快，第2组患者左室充盈速度正常，第3组患者左室充盈速度较慢。随着游离壁变薄受损导致左室峰值充盈率降低，1）快速充盈期持续时间，2）二尖瓣开放延迟，3）间隔与后壁之间的粘连，4）心绞痛发生率，5）房颤发生率逐渐增加。
SUMMARYIn order to study left ventricular function in idiopathic hypertrophic subaortic stenosis (IHSS), left ventricular echograms were analyzed by computer and compared with results in normal subjects. Systolic function was consistently normal or above normal even in the presence of severe diastolic abnormalities. Wide variation in diastolic function in IHSS allowed separation of patients into three groups on the basis of the left ventricular peak filling rate. Because of the severe septal hypertrophy and hypokinesia, peak left ventricular filling rate is predominantly determined by the rate of free wall thinning. Patients in group 1 had rapid left ventricular filling rates, those in group 2 had normal filling rates, and those in group 3 had slow filling rates. With reduction in left ventricular peak filling rate caused by impaired free wall thinning, there was progressive increase in 1) duration of the rapid filling phase, 2) delay of mitral valve opening, 3) asynchrony between septum and posterior wall, 4) incidence of angina, and 5) incidence of atrial fibrillation.