Differences in myocardial velocity gradient measured throughout the cardiac cycle in patients with hypertrophic cardiomyopathy, athletes and patients with left ventricular hypertrophy due to hypertension
Differences in myocardial velocity gradient measured throughout the cardiac cycle in patients with hypertrophic cardiomyopathy, athletes and patients with left ventricular hypertrophy due to hypertension
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DOI：
10.1016/s0735-1097(97)00231-3
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发表时间：
1997-09-01
影响因子：
24
通讯作者：
Fox, KAA
中科院分区：
文献类型：
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作者：
Palka, P;Lange, A;Fox, KAA
目标。我们试图比较肥厚型心肌病(HCM)患者、运动员和系统性高血压所致的LV肥厚患者在心动周期中跨左室(LV)后壁测量的心肌速度梯度(MVG)，并确定其是否可以用于区分这些组。MVG是基于彩色多普勒技术的一种新的超声变量，用于量化经心肌血流速度的空间分布。根据年龄将158名受试者细分为两组：I组(平均[+/-SD]30+/-7岁)和II组(58+/-8岁)。每组包括3类受试者：LA组25例，Ib组21例，正常人21例，IIa组19例，IIb组27例，IIc组33例。肥厚性心肌病组(Ia3.2+/-1.1；IIa2.9+/-1.2)的MVG(平均值[+/-SD]S(-1))显著低于运动员(Ib4.6+/-1.1组)、高血压患者(IIb4.2+/-1.8组)和正常人(IC4.4+/-0.8组；Ile 4.8+/-0.8)，在舒张期早期，肥厚型心肌病患者(Ia 3.7+/-1.5；Ia 2.6+/-0.9)的MVG低于运动员(Ib 9.9+/-1.9)和正常人(Ic 9.2+/-2.0；IIc组(3.6+/-1.5)，而非高血压患者(IIb组3.3+/-1.3)，在Fate舒张期，肥厚型心肌病患者(Ia组1.3+/-0.8；IIa组1.4+/-0.8)的MVG较低(p<；与高血压患者(IIb4.3+/-1.7)和正常人(IIc3.5+/-0.9)相比，MVG小于或等于7 S(-1)作为单项诊断方法，能准确区分肥厚型心肌病患者和运动员舒张期早期的MVG，阳性预测值为0.96，阴性预测值为0.94。在两个年龄组中，肥厚性心肌病患者的收缩和舒张期MVG均低于运动员、高血压患者和正常人，18~45岁年龄组的舒张期MVG可作为区分肥厚性心肌病和肥厚的准确指标。(C)1997年由美国心脏病学会主办。
Objectives. We sought to compare the myocardial velocity gradient (MVG) measured across the left ventricular (LV) posterior wall during the cardiac cycle between patients with hypertrophic cardiomyopathy (HCM), athletes and patients with LV hypertrophy due to systemic hypertension and to determine whether it might be used to discriminate these groups.Background. The MVG is a new ultrasound variable, based on the color Doppler technique, that quantifies the spatial distribution of transmyocardial velocities.Methods. A cohort of 158 subjects was subdivided by age into two groups: Group I (mean [+/-SD] 30 +/- 7 years) and Group II (58 +/- 8 years). Within each group there were three categories of subjects: Group la consisted of patients with HCM (n = 25), Group Ib consisted of athletes (n = 21), and Group Ic consisted of normal subjects; Group IIa consisted of patients with HCM (n = 19), Group IIb consisted of hypertensive patients (n = 27), and Group IIc consisted of normal subjects (n = 33).Results. The MVG (mean [+/-SD] s(-1)) measured in systole was lower (p < 0.01) in patients with HCM (Group Ia 3.2 +/- 1.1; Group IIa 2.9 +/- 1.2) compared with athletes (Group Ib 4.6 +/- 1.1), hypertensive patients (Group IIb 4.2 +/- 1.8) and normal subjects (Group Ic 4.4 +/- 0.8; Group Ile 4.8 +/- 0.8), In early diastole, the MVG was lower (p < 0.05) in patients with HCM (Group Ia 3.7 +/- 1.5; Group IIa 2.6 +/- 0.9) than in athletes (Group Ib 9.9 +/- 1.9) and normal subjects (Group Ic 9.2 +/- 2.0; Group IIc 3.6 +/- 1.5), but not hypertensive patients (Group IIb 3.3 +/- 1.3), In fate diastole, the MVG in patients with HCM (Group Ia 1.3 +/- 0.8; Group IIa 1.4 +/- 0.8) was lower (p < 0.01) than that in hypertensive patients (Group IIb 4.3 +/- 1.7) and normal subjects (Group IIc 3.5 +/- 0.9), An MVG less than or equal to 7 s(-1), as a single diagnostic approach, differentiated accurately (0.96 positive and 0.94 negative predictive value) between patients with HCM and athletes when the measurements were taken during early diastole.Conclusions. In both age groups, the MVG was lower in both systole and diastole in patients with HCM than in athletes, hypertensive patients or normal subjects, The MVG measured in early diastole in a group of subjects 18 to 45 years old would appear to be an accurate variable used to discriminate between HCM and hypertrophy in athletes. (C) 1997 by the American College of Cardiology.