Study On The Relationship Between Cardiac Contrast Echocardiography And Electrocardiogram In Patients With Hypertrophic Cardiomyopathy

Objective:To demonstrate the microcirculatory perfusion of hypertrophic myocardium by contrast echocardiography((MCE),and to evaluate the relationship between myocardial microcirculation and electrocardiogram(ECG).Methods:32 patients with HCM(HCM group)and 28 healthy volunteers(control group)were examined by MCE,and the images were accessed as required.Map reading analysis:the central area of hypertrophic myocardium was selected as the region of interest,and the time-intensity myocardial perfusion curve was obtained by software.After gamma fitting,four ultrasound perfusion parameters were obtained:peak intensity(PI),area under the curve(AUC),rise slope(RS),to peak time(TTP).The repeatability of ultrasonic perfusion parameters measured twice by different observers was tested.The ultrasonic perfusion parameters of the HCM group and the control group were compared,and the correlation between the statistically significant perfusion parameters and the degree of downward movement of ST-T was analyzed to explore the relationship between the depression of different ST segments and the disturbance of myocardial microcirculation.Results:in the repeatability test,the ultrasound perfusion parameters of the four groups showed good repeatability.PI and AUC in the HCM group were lower than those in the control group(t=12.530,P<0.001;t=11.134 P<0.001),RS and TTP,there was no significant difference between the two groups(t=1.489,P=0.145;t=0.033,P=0.973).There were ST-T changes in all the patients in the HCM group(t=8.294.P<0.001;t=6.298,P<0.001),and the electrocardiogram in the control group was negative.The correlation coefficients between PI and ST segment depression and T wave inversion or flattening were r=-0.348(P=0.051)and r=-0.141(P=0.442),respectively,indicating that there was no significant difference between PI and T wave inversion or flatness correlation,PI and T wave inversion or flatness were not correlated;when the degree of ST segment depression in HCM group was divided into groups,when 0.15mV and 0.2mV were divided into cutoff groups,the PI values of the two subgroups were different,and when 0.1 mV was used as the cutoff value,the PI values of the two subgroups were different.There was no significant difference in PI between the two subgroups.Conclusion:the microcirculatory perfusion of hypertrophic myocardium is significantly decreased in hypertrophic cardiomyopathy,and the changes of PI and AUC are more obvious.It is found that there is no significant correlation between PI and ECG ST-T depression.When the ST segment is depressed to a certain extent,it shows that there is a certain relationship between ST segment depression and myocardial microcirculation perfusion in the hypertrophic part.