CAJ | 학술논문

目的：通过彩色Doppler超声心动图评价左室射血分数正常的心肌肥厚心力衰竭患者左室流出道（ LV-OT）压差及心房功能的变化。方法选择52例正常人作为正常组，53例无梗阻型肥厚性心肌病心力衰竭患者作为无梗阻组，66例梗阻型肥厚性心肌病心力衰竭患者作为梗阻组，其中128例进行多巴酚丁胺负荷脉冲型、连续波型彩色多普勒超声心动图检查。测定3组LVOT压差及左房内径。结果无梗阻组和梗阻组患者左室短轴内径明显小于正常组，梗阻组LVOT压差较无梗阻组明显增加，心房内径明显增大，A峰明显增高，2组比较均有显著性差异（ P均＜0．05）；E/A比值与3组比较无显著性差异。结论 LVOT梗阻型肥厚性心肌病心力衰竭患者心房功能明显改变，负荷超声、心房功能评价有助于评价梗阻型肥厚性心肌病心力衰竭患者LVOT压差和心房功能。
목적：통과채색Doppler초성심동도평개좌실사혈분수정상적심기비후심력쇠갈환자좌실류출도（ LV-OT）압차급심방공능적변화。방법선택52례정상인작위정상조，53례무경조형비후성심기병심력쇠갈환자작위무경조조，66례경조형비후성심기병심력쇠갈환자작위경조조，기중128례진행다파분정알부하맥충형、련속파형채색다보륵초성심동도검사。측정3조LVOT압차급좌방내경。결과무경조조화경조조환자좌실단축내경명현소우정상조，경조조LVOT압차교무경조조명현증가，심방내경명현증대，A봉명현증고，2조비교균유현저성차이（ P균＜0．05）；E/A비치여3조비교무현저성차이。결론 LVOT경조형비후성심기병심력쇠갈환자심방공능명현개변，부하초성、심방공능평개유조우평개경조형비후성심기병심력쇠갈환자LVOT압차화심방공능。
Objec itve It is to evaluate the changes of left ventricular outflow tract ( LVOT)gradiant,left atrial reserve function in patients with hypertrophic cardiomyopathy with normal left ventricular ejection fraction by color Doppler echocardio -graphy .Methods 52 normal subjects were selected as normal group , 53 patients with hypetrophic non -obstructive cardiomy-opathy and heart failure were selected as non-obstructive group , 66 patients with hypertrophic obstructive cardiomyopathy and heart failure were selected as obstructive group ,122 of 171 subjects of the three groups underwent Dobutamin stress echocardio-graphy , and their LVOT gradiant and left auricle internal dimension were detected .Results Compared with normal subjects , left atrial dimension were dilated in the patients in non -obstructive group and obstructive group .Compared with non -ob-structive group , LVOT gradiant , atrial dimension and A wave obviously increased in obstructive group , the differences were significant between the two groups (P<0.05).There was no significant difference in the ratio of E wave velocity and A wave velocity between non -obstructive group and normal group .Conclusion Atrial function changed much in the patients with LV -OT obstructive hypertrophic cardiomyopathy and heart failure .Dobutamine stress echocardiography is a useful approach to eval-uate left ventricular outflow obstruction in such patients .