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首页> 外文期刊>American Journal of Physiology >Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction.
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Improvement in diastolic intraventricular pressure gradients in patients with HOCM after ethanol septal reduction.

机译：乙醇中隔减少后HOCM患者舒张期脑室内压力梯度的改善。

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摘要

We sought to validate measurement of intraventricular pressure gradients (IVPG) and analyze their change in patients with hypertrophic obstructive cardiomyopathy (HOCM) after ethanol septal reduction (ESR). Quantitative analysis of color M-mode Doppler (CMM) images may be used to estimate diastolic IVPG noninvasively. Noninvasive IVPG measurement was validated in 10 patients undergoing surgical myectomy. Echocardiograms were then analyzed in 19 patients at baseline and after ESR. Pulsed Doppler data through the mitral valve and pulmonary venous flow were obtained. CMM was used to obtain the flow propagation velocity (Vp) and to calculate IVPG off-line. Left atrial pressure was estimated with the use of previously validated Doppler equations. Data were compared before and after ESR. CMM-derived IVPG correlated well with invasive measurements obtained before and after surgical myectomy [r = 0.8, P < 0.01, Delta(CMM - invasive IVPG) = 0.09 +/- 0.45 mmHg]. ESR resulted in a decrease of resting LVOT systolic gradient from 62 +/- 10 to 29 +/- 5 mmHg (P < 0.001). There was a significant increase in the Vp and IVPG (from 48 +/- 5to 74 +/- 7 cm/s and from 1.5 +/- 0.2 to 2.6 +/- 0.3 mmHg, respectively, P < 0.001 for both). Estimated left atrial pressure decreased from 16.2 +/- 1.1 to 11.5 +/- 0.9 mmHg (P < 0.001). The increase in IVPG correlated with the reduction in the LVOT gradient (r = 0.6, P < 0.01). Reduction of LVOT obstruction after ESR is associated with an improvement in diastolic suction force. Noninvasive measurements of IVPG may be used as an indicator of diastolic function improvement in HOCM.
机译：我们试图验证测量室间隔内压力梯度（IVPG）并分析乙醇间隔减少（ESR）后肥厚性梗阻性心肌病（HOCM）患者的变化。彩色M型多普勒（CMM）图像的定量分析可用于无创估计舒张期IVPG。无创IVPG测量在10例行外科手术切除术的患者中得到验证。然后在基线和ESR后分析19例患者的超声心动图。获得通过二尖瓣和肺静脉血流的脉冲多普勒数据。 CMM用于获得流量传播速度（Vp）并离线计算IVPG。使用先前验证的多普勒方程估算左心房压力。在ESR前后比较数据。 CMM衍生的IVPG与手术肌切除术前后获得的侵入性测量值相关性很好[r = 0.8，P <0.01，Delta（CMM-侵入性IVPG）= 0.09 +/- 0.45 mmHg]。 ESR导致静息LVOT收缩压梯度从62 +/- 10 mmHg降低到29 +/- 5 mmHg（P <0.001）。 Vp和IVPG显着增加（分别从48 +/- 5到74 +/- 7 cm / s和从1.5 +/- 0.2到2.6 +/- 0.3 mmHg，两者均P <0.001）。估计的左心房压力从16.2 +/- 1.1降至11.5 +/- 0.9 mmHg（P <0.001）。 IVPG的增加与LVOT梯度的降低相关（r = 0.6，P <0.01）。 ESR后LVOT阻塞的减少与舒张力的提高有关。 IVPG的非侵入性测量可以用作HOCM舒张功能改善的指标。

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