我们的网站为什么显示成这样？

可能因为您的浏览器不支持样式，您可以更新您的浏览器到最新版本，以获取对此功能的支持，访问下面的网站，获取关于浏览器的信息：

|本期目录/Table of Contents|

实时三维超声评估肥厚型心肌病左室收缩与舒张失同步性的关系

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2015年第2期
页码:
194-197201
栏目:
临床研究
出版日期:
2014-10-25

文章信息/Info

Title:
Correlation of systolic and diastolic dyssynchrony in patients with hypertrophic cardiomyopathy: a study using real-time three-dimensional echocardiography
作者:
赵 蓓1; 智 光2; 陈劲松3; 王 晶2; 周 肖2; 王守力1
(1.解放军第306医院心内科，北京 100101；
2.解放军总医院心内科，北京 100853；
3.解放军175医院心内科，福建 漳州 363000)
Author(s):
ZHAO Bei1;  ZHI Guang2;  CHEN Jin-song3;  WANG Jing2;  ZHOU Xiao2;  WANG Shou-li1
(1.Department of Cardiology, PLA 306th Hospital, Beijing 100101, China；
2.Department of Cardiology, PLA General Hospital, Beijing 100853, China；
3.Department of Cardiology, PLA 175 Hospital, Zhangzhou 363000, Fujian, China)
关键词:
单心动周期实时三维超声; 心肌病; 肥厚型; 舒张失同步性; 收缩失同步性
Keywords:
single-beat real-time three-dimensional echocardiography;  hypertrophic cardiomyopathy;  diastolic dyssynchrony;  systolic dyssynchrony
分类号:
R542.2;R730.41
DOI:
-
文献标识码:
A
摘要:
目的:运用单心动周期实时三维超声探讨肥厚型心肌病左室舒张失同步性与收缩失同步性的关系。方法:收集76例窦性心律且左室射血分数≥45%的肥厚型心肌病患者及50例正常对照人群，应用二维及三维超声评估收缩功能与舒张功能。三维超声主要评估参数包括：舒张末球形指数（EDSI），舒张失同步指数（DDI），舒张离散差（DISPED），平均舒张末时间（MED），收缩末球形指数（ESSI），收缩失同步指数（SDI），收缩离散差（DISPES），平均收缩末时间（MES）。将患者按传统二维超声舒张功能的分级标准分为3组：舒张功能轻度受损（22例）、舒张功能假性正常（36例）和舒张功能限制性充盈（18例）。结果:在舒张期，较正常对照组， DDI、DISPED及MED均在舒张功能严重不全（限制性充盈）组中表现出明显升高（9.95±3.75，41.76±17.19，57.82±17.07，P<0.01），并且与轻度（轻度受损）组及中度（假性正常）组相比，有逐渐升高的趋势。在收缩期，SDI和DISPES也在舒张功能严重不全（限制性充盈）组中表现出明显升高（8.61±2.32，37.29±9.67，P<0.01），而在轻度（轻度受损）组及中度（假性正常）组中均无显著差异。SDI与DDI存在线性相关（R2=0.653，P<0.01）。结论:肥厚型心肌病舒张失同步性与收缩失同步性密切相关，严重左室舒张功能不全可能影响左室收缩的失同步性。
Abstract:
AIM:To examine 24-h dynamic electrocardiogram changes of senile bronchial asthma during acute and stable periods in elderly patients. METHODS: Seventy-six patients (54 male, 22 female) aged 60-89(74±8) years were included in this study. Patients had a history of asthma between 2 and 31(12±9) years. Twenty-four-hour dynamic electrocardiogram was performed, respectively, during acute period and 2 weeks after the stable period. RESULTS: There were significant differences in maximum heart rate ［(142±31) vs.(113±17) 1/min］, minimum heart rate ［(76±9) vs.(54±11) 1/min］, mean heart rate ［(95±16) vs.(73±13) 1/min］, supraventricular premature beats ［(353±72) vs.(92±37) 1/24 h］, ventricular premature beats ［(327±75) vs.(98±27) 1/24 h］, supraventricular tachycardia cases (69 vs. 15), atrial fibrillation cases (28 vs. 12), ST-T change cases (59 vs. 23) and J-wave cases (21 vs. 4) between acute and stable periods (P<0.05 or P<0.01). CONCLUSION: Asthma during acute period can induce varied electrocardiogram changes and arrhythmia, possibly due to anoxia, catecholamine increase, right ventricular hypertrophy, and acid-base and electrolyte disorders.

参考文献/References

[1]Olivotto I,Girolami F,Ackerman MJ,et al.Myofilament protein gene mutation screening and outcome of patients with hypertrophic cardiomyopathy[J].Mayo Clinic Proceedings,2008,83(6):630-638.
[2]Carasso S,Yang H,Woo A,et al. Diastolic myocardial mechanics in hypertrophic cardiomyopathy[J].Journal of the American Society of Echocardiography, 2010,23(2):164-171.
[3]Vinereanu D,Nicolaides E,Tweddel AC,et al.Pure diastolic dysfunction is associated with long-axis systolic dysfunction.implications for the diagnosis and classification of heart failure[J].Eur J Heart Fail,2005,7(5):820-828.
[4]Marsan NA,Bleeker GB,Ypenburg C,et al.Real-time three-dimensional echocardiography permits quantification of left ventricular mechanical dyssynchrony and predicts acute response to cardiac resynchronization therapy[J].J Cardiovasc Electrophysiol,2008,19(4):392-399.
[5]Wigle ED,Sasson Z,Henderson MA,et al.Hypertrophic cardiomyop-athy.The importance of the site and the extent of hypertrophy[J].Prog Cardiovasc Dis,1985,28(1):1-83.
[6]Maurer MS.Heart failure with a normal ejection fraction(HFNEF):embracing complexity[J].J Card Fail,2009,15(7):561-564.
[7]Nagueh SF,Appleton CP,Gillebert TC,et al.Recommendations for the evaluation of left ventricular diastolic function by echocardiography[J].J Am Soc Echocardiogr,2009, 22(2):107-133.
[8]Daneshvar D,Wei J,Tolstrup K,et al.Diastolic dysfunction:improved understanding using emerging imaging techniques[J].Am Heart J,2010,160(3):394-404.
[9]Ho CY,Sweitzer NK,Mcdonough B,et al.Assessment of diastolic function with Doppler tissue imaging to predict genotype in preclinical hypertrophic cardiomyopathy[J].Circulation,2002,105(25):2992-2997.
[10]Sanderson JE.Heart failure with a normal ejection fraction[J].Heart,2007,93(2):155-158.
[11]Komamura K.Similarities and Differences between the Pathogenesis and Pathophysiology of Diastolic and Systolic Heart Failure[J].Cardiol Res Pract,2013,2013:824135.
[12]Dini FL,Galderisi M,Nistri SA,et al.Abnormal left ventricular longitudinal function assessed by echocardiographic and tissue Doppler imaging is a powerful predictor of diastolic dysfunction in hypertensive patients:The SPHERE study[J].Int J Cardiol,2013,168(4):3351-3358.
[13]Marsan NA,Tops LF,Nihoyannopoulos PA,et al.Real-time three dimensional echocardiography:current and future clinical applications[J].Heart,2009,95(22):1881-1890.
[14]Auricchio A,Fantoni C,Regoli F,et al.Characterization of left ventricular activation in patients with heart failure and left bundle-branch block[J].Circulation,2004,109(9):1133-1139.
[15]Cheuk MY,Qing Z,Gabriel W,et al.Diastolic and systolic asynchrony in patients with diastolic heart heart failure[J].J Am Coll Cardiol,2007,49(1):97-105.
[16]Bleeker GB,Schalij MJ,Molhoek SG,et al.Relationship between QRS duration and left ventricular dyssynchrony in patients with end-stage heart failure[J].J Cardiovasc Electrophysiol,2004,15(5):544-549.

备注/Memo

备注/Memo:
收稿日期：2014-08-13.
通讯作者：王守力，主任医师，主要从事冠心病病理机制及介入治疗研究 Email：wangsl.63@126.com
作者简介：赵蓓，主治医师，博士 Email：rubyzhao1212@126.com
更新日期/Last Update: 2014-11-18