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[1]侯淑紅,陳東平,林瑜芬.心肌做功聯(lián)合心肺運(yùn)動(dòng)試驗(yàn)在肥厚型心肌病患者中的臨床應(yīng)用[J].福建醫(yī)藥雜志,2024,46(08):9-12.[doi:10.20148/j.fmj.2024.08.003]
　HOU Shuhong,CHEN Dongping,LIN Yufen.Clinical application of myocardial work combined with cardiopulmonary exercise test in patients with hypertrophic cardiomyopathy[J].FUJIAN MEDICAL JOURNAL,2024,46(08):9-12.[doi:10.20148/j.fmj.2024.08.003]
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心肌做功聯(lián)合心肺運(yùn)動(dòng)試驗(yàn)在肥厚型心肌病患者中的臨床應(yīng)用()
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《福建醫(yī)藥雜志》[ISSN:1002-2600/CN:35-1071/R]

卷:
46
期數(shù):
2024年08期
頁碼:
9-12
欄目:
臨床研究
出版日期:
2024-12-20

文章信息/Info

Title:
Clinical application of myocardial work combined with cardiopulmonary exercise test in patients with hypertrophic cardiomyopathy
文章編號(hào):
1002-2600(2024)08-0009-04
作者:
侯淑紅; 陳東平; 林瑜芬
福建醫(yī)科大學(xué)附屬龍巖市第一醫(yī)院醫(yī)學(xué)影像科,龍巖 364000
Author(s):
HOU Shuhong; CHEN Dongping; LIN Yufen
Department of Medical Imaging,the First Affiliated Longyan Hospital of Fujian Medical University, Longyan, Fujian 364000, China
關(guān)鍵詞:
心肌做功;  心肺運(yùn)動(dòng)試驗(yàn);  肥厚型心肌病;  臨床應(yīng)用
Keywords:
myocardial work;  cardiopulmonary exercise test;  hypertrophic cardiomyopathy;  clinical application
分類號(hào):
R540.45
DOI:
10.20148/j.fmj.2024.08.003
文獻(xiàn)標(biāo)志碼:
B
摘要:
目的 應(yīng)用心肌做功聯(lián)合心肺運(yùn)動(dòng)試驗(yàn)(CPET)對肥厚型心肌病(HCM)患者的心肺功能進(jìn)行評估,分析心肌做功參數(shù)和CPET參數(shù)與左室最大室壁厚度(MWT)的相關(guān)性。方法 選取2022年1月至2023年4月福建省龍巖市第一醫(yī)院確診的非梗阻性HCM患者55例(HCM組),選取同期健康志愿者55例作為對照組。經(jīng)CPET獲取峰值攝氧量(Peak VO2)、無氧閾(AT)、氧脈搏(VO2/HR)、代謝當(dāng)量(METs),比較兩組間的差異。采用二維超聲斑點(diǎn)跟蹤技術(shù),獲取整體縱向應(yīng)變(GLS)、達(dá)峰時(shí)間離散度(PSD),以及左室心肌整體有用功(GCW)、整體無用功(GWW),比較兩組在CPET前后左室心肌縱向應(yīng)變及心肌做功參數(shù)的差異。結(jié)果 與對照組相比,HCM組CPET參數(shù)Peak VO2、AT、VO2/HR和METs均明顯降低,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。心肌縱向應(yīng)變及做功參數(shù)的變化:與運(yùn)動(dòng)前相比,HCM組運(yùn)動(dòng)后GLS明顯減低,PSD明顯延長,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05),GCW無明顯增加; 對照組運(yùn)動(dòng)后GCW明顯增加,GLS和PSD無明顯改變。與對照組相比,HCM組運(yùn)動(dòng)前及運(yùn)動(dòng)后GLS和GCW均明顯減低,PSD明顯延長,差異均有統(tǒng)計(jì)學(xué)意義(P<0.05)。MWT與PSD呈正相關(guān)(r=0.84,P<0.001),與GCW呈負(fù)相關(guān)(r=-0.84,P<0.001),與Peak VO2呈弱負(fù)相關(guān)(r=-0.45,P<0.001)。結(jié)論 心肌做功聯(lián)合 CPET能夠早期發(fā)現(xiàn)HCM患者的心肺功能損害,為臨床決策提供依據(jù)。
Abstract:
Objective To evaluate the cardiopulmonary function in patients with hypertrophic cardiomyopathy(HCM)by myocardial word combined with cardiopulmonary exercise test(CPET), and to investigate the correlation between myocardial work parameters, CPET parameters and left ventricular wall thickness.Methods Fifty-five patients with non-obstructive hypertrophic cardiomyopathy diagnosed in the First Hospital of Longyan from January 2022 to April 2023 were included in the HCM group, and 55 healthy volunteers from the same period were included in the control group.Cardiopulmonary exercise test was performed to obtain peak oxygen uptake(Peak VO2), anaerobic threshold(AT), oxygen pulse(VO2/HR), metabolic equivalents(METs), and the differences of these indicators between the two groups were compared.Two-dimensional ultrasound speckle tracking technique was used to obtain the overall longitudinal strain(GLS), peak time dispersion(PSD), the overall useful work(GCW), and the overall unwanted work(GWW), and the differences in the longitudinal strain of the left ventricular myocardium and the parameters of the left ventricular myocardial work before and after cardiorespiratory exercise test between the two groups were compared.Results Compared with the control group, the CPET parameters of Peak VO2, AT, VO2/HR and METs were significantly lower in the HCM group, and the differences were all statistically significant(P<0.05).Changes in myocardial longitudinal strain and myocardial work parameters: compared with the pre-exercise period, the GLS was significantly reduced and the PSD was significantly prolonged after the exercise in the HCM group, and the differences were all statistically significant(P<0.05),while the GCW was not significantly increased; in the control group, the GCW was significantly increased after the exercise, however GLS and PSD did not change significantly.Compared with the control group, both pre- and post-exercise GLS and GCW were significantly reduced and PSD was significantly prolonged in the HCM group, and the differences were statistically significant(P<0.05).MWT was positively correlated with PSD(r=0.84, P<0.001), negatively correlated with GCW(r=-0.84, P<0.001), and negatively correlated with Peak VO2(r=-0.45, P<0.001).Conclusion Myocardial work combined with CPET can detect cardiopulmonary impairment in HCM patients at an early stage and provide a basis for clinical decision-making.

參考文獻(xiàn)/References:

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備注/Memo

備注/Memo:
基金項(xiàng)目:福建醫(yī)科大學(xué)啟航基金項(xiàng)目(2021QH1340); 龍巖市科技計(jì)劃聯(lián)合資金項(xiàng)目(2021LYF17037)
更新日期/Last Update: 2024-12-20