目的 利用3.0T心脏磁共振评价肥厚型心肌病(HCM)患者左心室轴向和纵向收缩功能.方法 应用二维快速平衡稳态采集快速成像技术对16例肥厚型心肌病患者(HCM组)及20例健康成年人(正常组)行磁共振电影检查,获得2组患者的左心室射血分数、纵向缩短率(LS)及左心室3个标准层面的轴向缩短率(FS),评价HCM患者左心室的轴向及纵向收缩功能.结果 HCM组患者均为非对称性左心室肥厚.HCM组左心室射血分数、FS均高于正常组,LS低于正常组(P<0.05或0.01).HCM组左心室基底部和中间部FS均高于正常组(P均<0.01),左心室心尖部FS两组间差异无统计学意义(P =0.057).Pearson相关分析显示,LS与心肌肥厚节段数呈负相关(r=-0.537,P=0.032),FS与心肌肥厚节段数无相关性(r=-0.090,P=0.739),FS与LS也无相关性(r =0.049,P=0.856).结论 HCM患者心脏的纵向收缩功能降低,而轴向收缩功能可能不受影响.LS较FS可能更准确地反映HCM患者心肌收缩功能的变化.
Objective To evaluate the left ventricular (LV) radial and longitudinal systolic function in hypertrophic cardiomyopathy (HCM) patients by 3.0 T MR.Methods Sixteen HCM (HCM group) and twenty normal adults (normal group) were examined with fast imaging employing steady-state (FIESTA) acquisition sequence of cardiac MRI.LV ejection fraction (LVEF),longitudinal shortening (LS)and fractional shortening (FS)in three standard levels were measured to analyze LV radial and longitudinal systolic function.Results Asymmetric hypertrophy was detected in all HCM patients.The LVEF and FS were significantly higher while LS was significantly lower in HCM group than those in normal group(P < 0.05or 0.01).FS at basal and middle levels were significantly higher in HCM group than in normal group (both P <0.01).FS in apex level was similar in the two groups(P =0.057).Pearson correlation analysis showed that LS was negatively related with the number of hypertrophy segments in HCM patients (r =-0.537,P =0.032).But there was no correlation between FS and the number of hypertrophy segments as well as FS and LS in HCM patients (r =-0.090,P =0.739 ; r =0.049,P =0.856).Conclusion The LV longitudinal systolic function was reduced but the LV radial systolic function remained unchanged in HCM patients,thus,LS changes could better reflect myocardial systolic function in HCM patients.