摘要
本研究旨在探讨造影超声心动图(CEcho)评价肥厚型心肌病(HCM)左室下壁肥厚的价值。选取2015年5月至2016年10月在四川大学华西医院诊断的HCM患者114例,均行常规超声心动图(Echo)和CEcho检查,其中45例行心脏磁共振检查(CMR),47例行动态心电图(Holter)检查。分析HCM患者中左室下壁肥厚发生的频次及其所占的比例,并进一步探索HCM伴下壁肥厚患者心脏结构及功能变化。结果显示:(1)CEcho对HCM患者下壁肥厚的检出率为60%,较Echo检出率(48%)明显增高。(2)与金标准CMR对比,CEcho测量下壁基底段及中段舒张及收缩末期厚度无明显差异,但有增高的趋势;Echo测值低于CMR(P<0.05)及CEcho(P<0.05)。(3)Bland-Altman分析显示,CEcho与CMR测量下壁厚度的一致性较好。和Echo与CMR测量下壁厚度的结果相比,CEcho与CMR测量下壁厚度差值的95%一致性界限(CI)较小。回归分析显示CEcho与CMR测量下壁厚度的拟合度较好。(4)Holter结果显示下壁肥厚患者出现室性早搏≥500次/24 h的概率大于下壁非肥厚患者。结果表明CEcho可以较敏感地检出左室下壁肥厚,而Echo可能低估左室下壁厚度。HCM伴下壁肥厚患者发生室性早搏事件的可能性有所增加。
We tried to explore the value of contrast echocardiography （CEcho） on evaluating hypertrophic cardiomyopathy （HCM） with the inferior wall hypertrophy. A total of 114 patients with HCM were investigated. All the patients received CEcho and routine echocardiography （Echo）, and 45 of them received cardiac magnetic resonance （CMR） and 47 of them received Holter. The frequency and percentage of inferior wall hypertrophy were analyzed in HCM patients, as well as the structure and function. The results showed that： （1） Inferior wall hypertrophy was detected in 55 patients （48%） by Echo, while 68 patients （60%） by CEcho. （2） There was no significant difference between CMR and CEcho in the measurement of inferior wall at end-diastole and end-systole. Thickness of inferior wall by CEcho tended to be higher than CMR. However, the inferior wall thickness measured by Echo was obviously lower than that by CMR （P 〈 0.05） and CEcho （P 〈 0.05）. （3） Bland-Altman plot suggested good consistency between CEcho and CMR in measuring inferior wall thickness. 95% CI of mean differences in inferior wall thickness between CEcho and CMR were smaller in HCM patients as compared with that between Echo and CMR. Unary linear regression analysis showed good degree of ftting between CEcho and CMR. （4） Holter showed that HCM patients with inferior wall hypertrophy were likely to have higher incidence of premature ventricular complexes （PVC） ≥500/24 h. We demonstrate that CEcho is rather sensitive in detecting inferior wall hypertrophy. Echo may underestimate the inferior wall thickness. The risk of ventricular premature beats may increase in HCM patients with inferior hypertrophy.
出处
《生物医学工程学杂志》
EI
CAS
CSCD
北大核心
2018年第1期92-98,共7页
Journal of Biomedical Engineering
关键词
肥厚型心肌病
造影超声心动图
下壁肥厚
hypertrophic cardiomyopathy
contrast echocardiography
inferior wall hypertrophy
