经皮间隔支化学消融治疗肥梗阻性心肌病_尤士杰（英文）.ppt

The symptoms Whether the obstruction produced the clinical symptoms? not only with the degree of outflow tract obstruction and outflow tract pressure gradient, as well as the obstruction site. But also with ventricular diastolic function and the adequacy of venous return is also closely related. Increase the heart before and after load and myocardial contractility often cause noticeable clinical symptoms. Therefore, it will become more apparent after exercise . The patients should be treatment. Diastolic dysfunction All patients had diastolic dysfunction – How the pressure gradient and symptoms And the extent and distribution of the hypertrophy has nothing to do. Whether normal or small ventricular cavity, due to increased heart weight, ventricular volume reduction, myocardial fibrosis, leaving ventricular stiffness increased, compliance decreased and caused the diastolic function damage. Pulmonary venous pressure and end-diastolic pressure were increased and heart disfunction. systolic function Systolic function is normal or supranormal in HCOM Both obstruction and non-obstruction, Systolic dysfunction occurs in small subset (10-15%) Result of progressive impairment of systolic function. This transformation: wall thinning, cavity dilation, and fibrosis, increased mortality 11% (annual ) and risk of SCD. Conventional UCG, M-mode, or EF, fractional shortening preserved despite impaiment long-axis function Tissue Doppler image (TD)-derived systolic velocities: in the basal inferoseptal and anterolateral wall routinely in all patients on subsequent scans. Myocardial ischemia Myocardial ischemia, the symptoms of angina pectoris are: High-power so that left ventricular myocardial oxygen consumption increased; Cardiac contraction strength of oppression the large myocardial coronary artery; Intramyocardial small coronary artery stenosis and intimal thickening abnormalities, leading to cardiac hypertrophy and coronary artery oxygen required due to an imba