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肥厚性心肌病冠状动脉造影特征及临床意义
Analysis of hypertrophic cardiomyopathy features and clinical significance of coronary angiography

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DOI:
作者:
夏丽萍 ，张书宁
XIA Liping* ，ZHANG Shuning,
作者单位:
浙江省上虞市人民医院心内科，上海复旦大学附属中山医院心内科
＊Department of cardiology ShangYu People’s Hospital ,ShangYu 312300 ,ZheJiang Province;Department of Cardiology,Zhongshan Hospital,Fudan University,Shanghai 200032,China
关键词:
梗阻型肥厚性心肌病；非梗阻型肥厚性心肌病；冠状动脉造影
Obstructive hypertrophic cardiomyopathy; Non-obstructive hypertrophic cardiomyopathy; Coronary angiography
摘要:
目的 分析肥厚性心肌病的冠状动脉造影特征及临床意义。方法 经心脏彩色多普勒超声及左室造影、心导管检查确诊的肥厚性心肌病64 例分成2组，A组为梗阻型肥厚性心肌病44例，B组为非梗阻型肥厚性心肌病20例，通过分析临床资料、冠脉病变、测量冠状动脉各分支近段内径，比较其冠状动脉分布及特点。结果 （1）两组基线临床资料的比较：冠心病高危因素无统计学差异（P＞0.05），心超检查SAM征、左室流出道压差、室间隔肥厚二者有统计学差异(P<0.01)。（2）冠脉造影的比较：A组间隔支肌桥的发生率高于B组，（32%VS5%，P<0.01）；A组左冠状动脉内径粗大者28例（63.6%），B组16例(53.3%)，左主干、前降支、回旋支、间隔支近段血管直径较B组冠状动脉增粗（P<0.05）；结论 梗阻型肥厚性心肌病患者间隔支肌桥发生率高，冠状动脉内径较非梗阻型肥厚型心肌病患者粗大，尤其是间隔支粗大，对临床上经皮导管化学消融有指导意义。
Objective: By analysing the coronary angiographic features of hypertrophic cardiomyopathy and find out its clinical significance. Methods: 64 Patients of hypertrophic cardiomyopathy, diagnosed by The heart of color Doppler ,left ventricular angiography and cardiac catheterization were divided into 2 groups. 44 cases of hypertrophic obstructive cardiomyopathy (Group A) and 20 cases of hypertrophic non-obstructive cardiomyopathy (B group).By analyzing the clinical data, coronary artery disease and the various branches of the coronary artery diameter, Finding out their features of coronary artery distribution. Results: (1)Comparison of two Group’s baseline clinical data: There has no significant difference for risk factors of coronary heart disease（P＞0.05）；Compared with difference of The heart of color doppler examination SAM symptoms, left ventricular outflow tract pressure and ventricular hypertrophy,which have statistical significance(P<0.01).(2)Comparison of two Group’s Coronary angiography: The incidence of coronary myocardial bridging in Group A has higher than that in group B（32%VS5%）,which has significantly difference（P<0.01）. Thick left coronary arteries were found in 28 cases of group A (63.6%), and in 16 of group B(53.3 %). In group A, the diameter of left main coronary artery, left anterior descending artery, circumflex artery and proximal septal branch were thicker than that in group B(P <0.05). Conclusion: Patients of Obstructive hypertrophic cardiomyopathy have higher incidence of coronary myocardial bridging and thicker diameter of Coronary artery,especially for spacing artery, compared with the non-obstructive patients,. It is meaningful in guiding Percutaneous catheter ablation.

 

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