H Yoshida, K Imataki, H Nagahana, F Ihoriya, Y Nakao, D Saito, S Haraoka
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引用次数: 0
摘要
为了阐明区分原发性高血压(EH)和肥厚性心肌病(HCM)引起的心脏肥厚的有用指标,我们检查了66例EH和46例HCM的标准12导联心电图、胸片和超声心动图(Echo)。16例EH和18例HCM记录体表等电位映射(MAPs)。HCM组室间隔厚度(IVST)、IVST/PWT比值(PWT =后壁厚度)大于EH组,左室舒张直径(LVDd)小于EH组。室间隔激活时间(SAT)与IVST (r = 0.55, p < 0.005)和IVST/PWT比值(r = 0.61, p < 0.005)直接相关,即QRS复合体中最大正电位从胸骨中线或左胸骨边界移动到左锁骨中线的时间间隔。当SAT时间大于30 msec, IVST大于25 mm, IVST/PWT比值大于2.0时,均属于HCM。当受试者仅限于IVST小于25 mm的患者时,HCM组的SAT显著大于EH组。这些数据提示,SAT可能反映了EH组和HCM组室间隔肥厚的病因学差异,MAPs的这些参数可能有助于区分EH和HCM引起的心脏肥厚。
Cardiac hypertrophy in hypertrophic cardiomyopathy and hypertension evaluated by echocardiography and body surface isopotential mapping.
To elucidate the useful indices for differentiating cardiac hypertrophy due to essential hypertension (EH) from that due to hypertrophic cardiomyopathy (HCM), we examined standard 12-lead ECGs, chest radiographs and echocardiograms (Echo) in 66 EH and 46 HCM cases. Body surface isopotential mappings (MAPs) were recorded in 16 cases of EH and 18 of HCM. The thickness of the interventricular septum (IVST) and the IVST/PWT ratio (PWT = the thickness of the posterior wall) were greater and left ventricular diastolic diameter (LVDd) was smaller in the HCM group than in the EH group. The septal activation time (SAT), the time interval during which the maximum positive potential moves from the mid-sternal line or the left sternal border to the left mid-clavicular line in the QRS complex, correlated directly with the IVST (r = 0.55, p less than 0.005) and the IVST/PWT ratio (r = 0.61, p less than 0.005). When the SAT was longer than 30 msec, the IVST was over 25 mm and the IVST/PWT ratio was over 2.0, all cases belonged to the HCM category. When subjects were limited to patients with IVST less than 25 mm, the SAT of the HCM group was significantly greater than that of the EH group. These data suggest that the SAT may reflect the etiological differences between the septal hypertrophy of the EH group and that of the HCM group, and that these parameters of MAPs may be helpful to distinguish cardiac hypertrophy due to EH from that due to HCM.