Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study based on layer-specific speckle tracking echocardiaography.
Assessment of left ventricular systolic function in hypertrophic cardiomyopathy patients with myocardial injury: a study based on layer-specific speckle tracking echocardiaography.
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肥厚型心肌病合并心肌损伤患者左心室收缩功能的评估：基于层特异性斑点追踪超声心动图的研究。
DOI：
10.1007/s10554-020-01921-6
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
an
中科院分区：
文献类型：
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作者：
Liu Wen;Zhang Yanfen;Liu Yan;Ma Chunyan;Yang Jun;Sun D;an
我们进行了这项研究，以调查左心室（LV）的收缩功能，在内膜，中层心肌，心外膜层的二维（2D）斑点追踪超声心动图（STE）在肥厚型心肌病（HCM）患者的心肌损伤的血清心肌肌钙蛋白I（cTnI）升高的指数。29例HCM伴心肌损伤患者、35例HCM无心肌损伤患者和91例健康对照者入组本研究。血清cTnI > 0.026 ng/mL定义为心肌损伤。在心内膜、中层心肌和心外膜层评估LV纵向和周向应变（LS和CS）。三组心肌层特异性LS和CS在所有三个层面上均存在显著性差异（均P < 0.001），从健康对照组到无心肌损伤的HCM患者再到有心肌损伤的HCM患者。以血清cTnI升高为心肌损害指标的HCM患者，心肌层特异性LS和CS降低最明显（均P < 0.05）。在HCM伴心肌损伤组中，除内膜增厚的CS（P> 0.05）外，肥厚节段（节段厚度≥ 15 mm）的LS和CS均显著降低（P <0.001）。对左室应变的分层特异性评估可能会提高对HCM伴心肌损伤患者左室收缩功能受损的理解，从而防止进一步的损伤。
We conducted this study to investigate left ventricle (LV) systolic function in endocardial, mid-myocardial, and epicardial layers by two-dimensional (2D) speckle tracking echocardiography (STE) in hypertrophic cardiomyopathy (HCM) patients with myocardial injury indexed by elevated serum cardiac troponin I (cTnI). Twenty-nine HCM patients with myocardial injury, thirty-five HCM patients without myocardial injury, and ninty-one healthy controls were enrolled in this study. Serum cTnI > 0.026 ng/mL was defined as myocardial injury. LV longitudinal and circumferential strain (LS and CS) were assessed in endocardial, mid-myocardial and epicardial layers. Layer-specific LS and CS differed significantly (allP< 0.001) among all three groups in all three layers, in a descending order from healthy controls to HCM patients without myocardial injury to HCM patients with myocardial injury. Layer-specific LS and CS were decreased the most in HCM patients with myocardial injury indexed by elevated seum cTnI (allP< 0.05). In HCM patients with myocardial injury, layer-specific LS and CS were significantly lower in the segments with greater hypertrophy (segmental thickness ≥ 15 mm) (allP< 0.001) except for endocardial CS (P> 0.05). Layer-specific evaluation of LV strain may improve understanding of impaired LV systolic function in HCM patients with myocardial injury, thus preventing further damage.