Analysis of Effects of Myocardial Dilatation and Restrictive Changes on Cardiac Structure and Function in Patients with Hypertrophic Cardiomyopathy and Heart Failure
YE Ting-chun, CHEN Qiu
42nd Hospital of the People's Liberation Army, Leshan, 614100, Sichuan province, China
Abstract:【Objective】To investigate the effects of dilatation and restrictive changes of myocardiumon on cardiac structure and functional characteristics in patients with hypertrophic cardiomyopathy and heart failure.【Methods】A total of 82 patients with hypertrophic cardiomyopathy who were admitted to our hospital from February 2013 to February 2018 were enrolled in this study. All patients underwent thoracic echocardiography and magnetic resonance imaging. According to the results of ultrasound examination, the patients were divided into the dilated group (n=56) and the restricted group (n=26). The left atrial anteroposterior diameter (LAD), left ventricular ejection fraction (LVEF), maximum left ventricular wall thickness (LVWT), left ventricular end diastolic diameter (LVEDD), left atrial enlargement, ventricular wall hypertrophy and delayed ventricular wall enhancement were recorded and analyzed.【Results】The average age of the dilated group was younger than that of the restricted group, and the proportion of males was significantly higher than that of the restricted group. The difference was statistically significant (P<0.05).There was no significant difference in heart rate and plasma NT-proBNP levels between the two groups (P>0.05). Left atrial anteroposterior diameter, mitral regurgitation ratio, left atrial enlargement ratio and right ventricular enlargement ratio did not show any significant difference between the two groups (P>0.05). The proportions of LVEF, LVWT, tricuspid regurgitation, left and right atrial enlargement were significantly lower in the dilated group than in the restricted group. The ratios of LVEDD, LVWT<11mm and LVEF <50% in the dilated group were significantly greater than those in the restricted group; the differences were statistically significant (P<0.05). The maximum ventricular wall thickness, interventricular septum, partial left ventricular free wall hypertrophy ratio and ratio of delayed enhancement of ventricular septal or apical ventricular wall in the dilated group were lower than those in the restricted group. The proportions of simple interventricular septum hypertrophy, interventricular septum and left ventricular free wall delayed enhancement in the dilated were higher than those in the restricted group (P<0.05).【Conclusion】 Restrictive and dilated cardiomyopathy has a significant effect on cardiac structure and function in patients with hypertrophic cardiomyopathy complicated with heart failure. The degree of myocardial fibrosis and the hypertrophic site of the ventricular wall are important factors leading to changes in restrictive and dilated cardiomyopathy.
叶廷春, 陈秋. 肥厚型心肌病并心力衰竭患者心肌扩张性及限制性改变对心脏结构及功能的影响[J]. 医学临床研究, 2020, 37(2): 216-219.
YE Ting-chun, CHEN Qiu. Analysis of Effects of Myocardial Dilatation and Restrictive Changes on Cardiac Structure and Function in Patients with Hypertrophic Cardiomyopathy and Heart Failure. JOURNAL OF CLINICAL RESEARCH, 2020, 37(2): 216-219.
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