| Objective:The purpose of this study was to analyze the differen ce and correlation between echocardiography and some measurements obtained by cardiac magnetic resonance technique in patients with hy pertrophic cardiomyopathy,in order to evaluate myocardial wall thick ness more accurately.At the same time,the relationship between clini cal risk factors for sudden death of HCM,echocardiography and elec trocardiogram and cardiacmri LGE enhancement was analyzed,so as to explore new indicators that can predict LGE positivity,In order to judge the prognosis of patients with hypertrophic cardiomyopathy an d provide evidence for clinical treatment decision-making.Methods:The clinical symptomssigns,electrocardiogram,echoca rdiography and enhanced nuclear magnetic resonance of 57 patients wi th hypertrophic cardiomyopathy from June 2015 to February 2019 we re analyzed retrospectively.The ECG characteristics of HCM patients were analyzed,The differences andcorrelation between the thickness of interventricular septum,apical thickness and left anterior and poste rior diameter were analyzed and compared between the two technique s.Among them,36 underwent cardiac enhanced nuclear magnetic exa mination.According to the results of cardiac enhanced nuclear magne tic resonance(LGE),they were divided into the LGE positive group(23 cases)and the LGE negative group(13 cases),to analyze whichclinical risk factors,Echocardiography and ECG indicators were relat ed to the LGE positive results.Results:ECG results showed that 17 cases(47.22%)of left vent ricular high voltage,left ventricular hypertrophy and repolarization we re abnormal,4 cases(11.11%)of left or right bundle branch block,33 cases(91.67%)of ST depression with or without T wave abnorm ality,2 cases of atrial fibrillation,5 cases of atrial premature beats and 1 case of abnormal Q wave.By analyzing the ECG characteristic s of 14 patients with apex hypertrophic cardiomyopathy,it was found that the ECG characteristics of apex hypertrophic cardiomyopathy pr esented a large,asymmetric inverted T wave(>1.0mv)of apex lead(v3-v5),and the amplitude of chest lead R wave increased,presentin g Rv4 >Rv5>Rv6.there were significant differences in the thickness of ventricular septum(P = 0.000),apical thickness(P = 0.045)and posterior diameters of the left atrium(P = 0.003)and Left ventricula r ejection fraction(P=0.000).Pearson correlation analysis showed t hat there was a correlation between the measured values of interven tricular septum thickness in the two groups(r=0.548 P < 0.01).The re was a correlation between the measurement of apical thicknessand left atrial diameterand Left ventricular ejection fraction in the two g roups(r=0.511 p=0.030 P < 0.05)(r=0.626 p=0.000 P<0.01)(r=0.396 p=0.002 P<0.05).The consistency analysis results of intraclass corr elation efficiency(ICC)showed that the ventricular septum thickness(ICC=0.517 P<0.01),apical thickness(ICC=0.293 P =0.055),anterior and posterior diameter of the left atrium(ICC=0.783 P<0.01),and lef t ventricular ejection fraction(ICC=0.213 P<0.05)were measured by the two techniques.The results of independent sample T-test and Fis her’s exact test showed that: among the risk factors for sudden death,the proportion of MWT≥30 mm was higher in the LGE positive gr oup,and the difference was statistically significant compared with theLGE negative group(P=0.032).There was no significant difference i n family history of syncope and SCD(P>0.05).Among the echocardi ographic indicators,MWT in the LGE positive group increased signif icantly compared with that in the LGE negative group(P=0.019),and there was no statistically significant difference in the remaining ultra sonic indicators(P>0.05).Among the ECG indicators,the proportion of TWI in the LGE positive group was higher,and the difference be tween the LGE positive group and the negative group was statisticall y significant(P = 0.036).The difference in the remaining ECG indic ators was not statistically significant(P>0.05).Coclusions:1.The ECG of Apex Hypertrophic Cardiomyopathy is characteristic.2.There were differences in interventricular septum thickness,a pical thickness,left atrial anteriorand posterior diameter and Left vent ricular ejection fractionin hypertrophic cardiomyopathy by transthoraci c echocardiography and enhanced myocardial magnetic resonance ima ging.Pearson correlation analysis showed:There is a moderate correl ation between the data measured by the two kinds of inspection.Intra class correlation coefficient of consistency analysis and evaluation of two different results for the same inspection method found that the c onsistency of the two kinds of inspection technology in the measure ment before and after the left atrium diameter uniformity is better(I CC > 0.75),interventricular septum thickness measurement on general consistency(ICC 0.40-0.75),left ventricularejection fraction(ICC <0.40)and the result was statistically significan.Multimodal imaging te chniques are encouraged to provide evidence-based evidence for accur ate diagnosis and treatment of hypertrophic cardiomyopathy.3.The median value of MWT in echocardiography was higher in the LGE positive group,and the incidence of TWI in the ECG was higher inthe LGE positive group.Among the risk factors for sudden death,the proportion of MWT≥30 mm was higher in the LGE positive group. |
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