肥厚型梗阻性心肌病室间隔酒精消融术后的临床随访研究-内科学(心血管病)专业论文.docxVIP

第三军医大学硕士学位论文 第三军医大学硕士学位论文 万方数据 万方数据 LVPW left ventricular posterior wall 左室后壁 MCE myocardial contrast echocardiography 心肌声学造影 MR mitral regurgitation 二尖瓣反流 NYHA New York Heart Association 纽约心脏协会 RBBB right bundle brunch block 右束支传导阻滞 RT-3DE real-time three dimensional echocardiography 实时三维超声心动图 SAM systolic anterior motion 收缩期前向运动（二尖瓣前叶） SCD sudden cardiac death 心脏性猝死 SSM surgical septal myectomy 室间隔心肌切除术 SV stroke volume 每搏量 UCG ultrasonic cardiography 超声心动图 2 A clinical follow-up study of alcohol septal ablation for patients with hypertrophic obstructive cardiomyopathy Abstract Background and Objective Hypertrophic cardiomyopathy (HCM) is a common genetic disease with a prevalence of 1:500. It is characterized by asymmetric myocardial hypertrophy, which is most obvious in the interventricular septum. The common symptoms of HCM are exertional dyspnea and chest pain, and younger individuals may be at higher risk of ventricular fibrillation and sudden cardiac death. Approximately two thirds of patients have significant left ventricular outflow tract gradient (LVOTG) at rest (≥30 mmHg) or at provocation (≥ 50 mmHg), which referred to as hypertrophic obstructive cardiomyopathy (HOCM). For drug-refractory HOCM, a surgical septal myectomy (SSM) or alcohol septal ablation (ASA) is recommended. However, ASA has been highly praised both at home and abroad as a less invasive, effective and safer alternative to the SSM for HOCM patients. In addition, its clinical efficacy differs from center to center though the short and mid-term effects are encouraging in most studies. The major complications of ASA include atrioventricular block (AVB) and acute mitral insufficiency, which play an important role in judging the safety of ASA. Intracoronary electrocardiogram (IC-ECG) in the target septal perforator was performed before and after ASA, which was helpful to evaluate the myocardial injury immediately by the elevation of ST segment. Real-time three dimensional echocardiography (