Differences of left ventricular systolic deformation in hypertensive patients with and without apical hypertrophic cardiomyopathy
Differences of left ventricular systolic deformation in hypertensive patients with and without apical hypertrophic cardiomyopathy
复制标题
DOI：
10.1186/1476-7120-11-40
复制
发表时间：
2013-11-14
影响因子：
1.9
通讯作者：
Hung, Ming-Jui
中科院分区：
文献类型：
--
作者：
Kao, Yu-Cheng;Lee, Ming-Feng;Hung, Ming-Jui
背景：我们检验了患有和不患有心尖肥厚型心肌病 (ApHCM) 的高血压患者的心尖心肌力学与其他心室节段不同的假设。方法：我们回顾性研究了患有和不患有 ApHCM 的高血压患者。通过二维斑点追踪超声心动图检查胸骨旁短轴的基底壁、中壁和心尖壁以及心尖 2、3 和 4 腔切面，检查左心室纵向、周向和径向应变。 结果：对 14 名连续患有高血压和 ApHCM 的患者和 14 名患有高血压但不患有 ApHCM 的患者进行了研究。与不患有 ApHCM 的高血压患者相比，患有 ApHCM 的高血压患者二尖瓣环收缩期峰值速度较低，舒张功能障碍更大。与不患有 ApHCM 的高血压患者相比，患有 ApHCM 的高血压患者的心尖纵向应变（-13.9% vs -21.9%，p = 0.010）和径向应变（4.4% vs 11.5%，p = 0.017）显着较低，且没有基极至心尖梯度。患有 ApHCM 的高血压患者的整体纵向应变（-15.6% vs -18.8%，p = 0.027）和周向应变（-16.1% vs -19.2%，p = 0.019）显着低于不患有 ApHCM 的高血压患者。在收缩参数中，整体纵向应变与患有 ApHCM 的高血压独立相关（比值比，1.457；95% 置信区间，1.002-2.119；p = 0.049）。结论：患有 ApHCM 的高血压患者存在心尖纵向和径向应变减少，但没有基部到心尖梯度。高血压患者的整体纵向应变与 ApHCM 独立相关。
Background: We tested the hypothesis that the apical myocardial mechanics differ from those of other ventricular segments in hypertensive patients with and without apical hypertrophic cardiomyopathy (ApHCM).Methods: We retrospectively studied hypertensive patients with and without ApHCM. Left ventricular longitudinal, circumferential, and radial strains were examined by two-dimensional speckle-tracking echocardiography at the basal, middle, and apical walls of the parasternal short-axis and apical 2-, 3- and 4-chamber views.Results: Fourteen consecutive patients with hypertension and ApHCM and 14 patients with hypertension without ApHCM were studied. Lower mitral annular peak systolic velocity and greater diastolic dysfunction were present in hypertensive patients with ApHCM than in hypertensive patients without ApHCM. Compared with hypertensive patients without ApHCM, hypertensive patients with ApHCM had significantly lower apical longitudinal (-13.9% vs -21.9%, p = 0.010) and radial strains (4.4% vs 11.5%, p = 0.017) without the base-to-apex gradient. The global longitudinal (-15.6% vs -18.8%, p = 0.027) and circumferential strains (-16.1% vs -19.2%, p = 0.019) were significantly lower in hypertensive patients with ApHCM than in hypertensive patients without ApHCM. Among systolic parameters, the global longitudinal strain was independently associated with hypertension with ApHCM (odds ratio, 1.457; 95% confidence interval, 1.002-2.119; p = 0.049).Conclusions: Reduced apical longitudinal and radial strains without a base-to-apex gradient were present in hypertensive patients with ApHCM. The global longitudinal strain was independently associated with ApHCM in hypertensive patients.