LEFT VENTRICULAR FILLING BY DOPPLER IN HYPERTROPHIC CARDIOMYOPATHY

几乎没有真正的非侵入性测试可以用来测量剩余的 心脏病患者的心脏舒张期功能。在这 应用脉冲多普勒技术评价二尖瓣血流速度的研究 109例患者左心室充盈和松弛的类型及特征 肥厚型心肌病患者和86例正常对照。全 超声心动图评价肥厚性心脏病患者的舒张期功能 心肌病与86名对照组显著不同 无相似年龄的心脏病(P<0.001)：持续时间 等容松弛(94.2加/负24对77.6加/负12毫秒)和 舒张期早期血流速度峰值持续时间(245加/减54 与220加/减28毫秒相比)均延长，且下降的速度 舒张期早期流速下降舒张期充盈速度 减少(3.4加/减1.4对4.9加/减1.4米/秒2)；作为 明显补偿受损的松弛和早期舒张期充盈， 心房对左心室充盈的贡献增加，如图所示。 通过降低早期和晚期(心房)高度之比 流速峰值(1.5正/负0.8比2.1正/负0.9)。这个 绝大多数肥厚型心肌病患者有证据表明 左室舒张功能受损的临床研究 多普勒波形(--109例，占77%)。舒张期功能不全 在没有左心室的患者中发现相似的频率 流出端梗阻(78%)或伴有梗阻(70%)，以及 无症状(73%)或有症状患者(82%)。这些发现 证明脉冲多普勒超声心动图可用于 定量评估左心功能和左心功能损害 脑室充盈和松弛是常见的，临床上也很重要。 肥厚型心肌病患者群体中的异常。

There are few truly non-invasive tests available to measure left ventricular diastolic function in patients with cardiac disease. In this study we utilized pulsed Doppler to assess transmitral flow-velocity patterns and characterize left ventricular filling and relaxation in 109 patients with hypertrophic cardiomyopathy and 86 normal controls. All Doppler indexes of diastolic function in patients with hypertrophic cardiomyopathy differed significantly from those in 86 control subjects without heart disease of similar ages (p less than 0.001): duration of isovolumic relaxation (94.2 plus/minus 24 versus 77.6 plus/minus 12 ms) and duration of the early diastolic peak of flow-velocity (245 plus/minus 54 versus 220 plus/minus 28 ms) were both prolonged and the rate of decrease (descent) of flow-velocity in early diastole diastolic filling velocity was reduced (3.4 plus/minus 1.4 versus 4.9 plus/minus 1.4 m/sec2); as an apparent compensation for impaired relaxation and early diastolic filling, the atrial contribution to left ventricular filling was increased, as shown by the reduced ratio between the heights of the early and late (atrial) peaks of flow-velocity (1.5 plus/minus 0.8 versus 2.1 plus/minus 0.9). The vast majority of patients with hypertrophic cardiomyopathy showed evidence of impaired left ventricular diastolic function based on alterations in the Doppler waveform (-- of 109 patients, or 77%). Diastolic dysfunction was identified with similar frequency in patients without left ventricular outflow obstruction (78%) or with obstruction (70%), as well as in asymptomatic (73%) or symptomatic patients (82%). These findings demonstrate that pulsed Doppler echocardiography may be used to quantitatively assess left ventricular function and that impairment in left ventricular filling and relaxation are common and clinically important abnormalities in a population of patients with hypertrophic cardiomyopathy.