QUANTITATIVE ASSESSMENT OF ULTRASONIC MYOCARDIAL REFLECTIVITY IN HYPERTROPHIC CARDIOMYOPATHY
QUANTITATIVE ASSESSMENT OF ULTRASONIC MYOCARDIAL REFLECTIVITY IN HYPERTROPHIC CARDIOMYOPATHY
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DOI：
10.1016/0735-1097(91)90836-x
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发表时间：
1991-04-01
影响因子：
24
通讯作者：
LABBATE, A
中科院分区：
文献类型：
--
作者：
LATTANZI, F;SPIRITO, P;LABBATE, A
本研究的目的是探讨肥厚性心肌病患者心肌声学特性与左心室肥厚程度的关系。采用在线射频分析系统对25例肥厚性心肌病患者和25例年龄匹配的正常对照组的室间隔和后游离壁的综合后向散射信号进行了定量测量。对心包界面射频信号的积分值进行归一化，并以百分比表示。肥厚性心肌病患者肥厚的室间隔以及非肥厚的后游离壁的组织反射率与正常受试者（分别为33 +/- 10%和18 +/- 5%，p < 0.001）相比显著增加（分别为58 +/- 15%和37 +/- 12%）。此外，在90%的患者中，室间隔或后游离壁或两者的反射率测量值超过正常值的2个标准差，并且在只有轻度和局部左室肥厚的5例研究患者中，每个患者的反射率都异常。肥厚型心肌病患者心肌组织反射率与左室壁厚度无相关性（相关系数r = 0.4; p = NS）。这些结果表明，心肌反射率在大多数肥厚性心肌病患者中是异常的，并且在很大程度上与左心室肥厚的程度无关。此外，超声反射率的定量分析可以独立于临床特征和常规超声心动图测量来区分肥厚性心肌病患者和正常人。
The purpose of this study was to investigate the relation between acoustic properties of the myocardium and magnitude of left ventricular hypertrophy in patients with hypertrophic cardiomyopathy. An on-line radio frequency analysis system was used to obtain quantitative operator-independent measurements of the integrated backscatter signal of the ventricular septum and posterior free wall in 25 patients with hypertrophic cardiomyopathy and 25 normal age-matched control subjects. The integrated values of the radio frequency signal were normalized for the pericardial interface and expressed in percent.Tissue reflectivity was significantly increased in the hypertrophied ventricular septum, as well as in the nonhypertrophied posterior free wall, in patients with hypertrophic cardiomyopathy (58 +/- 15% and 37 +/- 12%, respectively) compared with values in normal subjects (33 +/- 10% and 18 +/- 5%, respectively; p < 0.001). Furthermore, measurements of reflectivity of the septum or posterior free wall, or both, were beyond 2 SD of normal values in > 90% of the patients and were also abnormal in each of the five study patients who had only mild and localized left ventricular hypertrophy. No correlation was identified between myocardial tissue reflectivity and left ventricular wall thickness in the patients with hypertrophic cardiomyopathy (correlation coefficient r = 0.4; p = NS).These findings demonstrate that myocardial reflectivity is abnormal in most patients with hypertrophic cardiomyopathy and is largely independent of the magnitude of left ventricular hypertrophy. Moreover, quantitative analysis of ultrasonic reflectivity can differentiate patients with hypertrophic cardiomyopathy from normal subjects independently of clinical features and conventional echocardiographic measurements.