BackgroundThere has been limited data addressing outcomes of extensive septal myectomy in Chinese patients with hypertrophic obstructive cardiomyopathy (HOCM). In this study, the objective was to evaluate the clinical and echocardiographic outcomes of extensive septal myectomy in a relative large number of Chinese HOCM patients over long-term follow-up.MethodsWe retrospectively studied 139 consecutive HOCM patients (age 43 ± 15 years, 37 % male) who underwent extensive left ventricular septal myectomy. During the perioperative period, all patients were examined by echocardiography. All-cause death and cardiac death were considered as primary endpoints during follow-up. Perioperative data was obtained by retrospective review of institutional surgical databases. Follow-up data of echocardiography and clinical status was recorded through outpatient interview.ResultsPerioperative events consisted of arrhythmia, retraction injury to aortic valve leaflets, pleural effusion, and hemodialysis and the use of intra-aortic balloon pump. There was no in-hospital mortality. The follow-up period averaged 5.6 ± 0.9 years and overall survivals were 100.0, 99.3, 99.3, 98.5 and 97.8 % at 1, 2, 3, 4 and 5 years, respectively. Left ventricular outflow tract (LVOT) gradient decreased form preoperative 84 ± 17 mmHg to 12 ± 3 mmHg at 2.5 years after surgery and it further reduced to 6 ± 3 mmHg at 5 years after surgery (P < 0.05). Compared with the preoperative levels, interventricualr septal thickness decreased by 32 % while diastole left ventricular inner diameter approximately increased by 10 % and ejection fraction (EF) was significantly elevated during follow-up (P < 0.05). By echocardiography detection, mitral regurgitation was ameliorated for HOCM patients after surgery. There was significant improvement in New York Heart Association (NYHA) class. The proportion of NYHA III and IV decreased from preoperative 58 to 19 % at 2.5 years after surgery and it reduced to 11 % at 5 years after operation.ConclusionExtensive septal myectomy offers minimal operative risk and provides long-term relief for LVOT obstruction in Chinese HOCM patients.

Objective. To explore the value of color Doppler echocardiography (CDE) combined with serum heart-type fatty acid-binding protein (h-FABP) and cardiac troponin I (cTnI) in the diagnosis of myocardial infarction and its evaluation value in left ventricular function. Methods. A total of 44 patients with myocardial infarction who were treated in Cangzhou Central Hospital from October 2018 to February 2020 were included in the observation group, and 45 healthy subjects were included in the control group. The serum h-FABP and cTnI levels of the two groups were compared and analyzed. The coincidence rate of echocardiography plus serum h-FABP and cTnI for single diagnosis and combined diagnosis was analyzed. The left ventricular function indexes of patients with myocardial infarction in different cardiac function grades were compared, including left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), left ventricular end-systolic volume (LVESV), left ventricular end-diastolic volume (LVEDV), stroke volume (SV), cardiac index (CI), and the ratio of peak velocity blood flow from left ventricular relaxation in early diastole to peak velocity flow in late diastole (E/A). The value of echocardiography combined with serum h-FABP and cTnI in the left ventricular function in patients with myocardial infarction was analyzed. Results. The levels of serum h-FABP and cTnI in the observation group were significantly higher than those in the control group ( P < 0.05 ). CDE plus serum h-FABP and cTnI was associated with significantly higher sensitivity, specificity, and accuracy in diagnosing myocardial infarction versus single detection ( P < 0.05 ). The LVEDV, SV, and CI parameters were similar in patients with different cardiac function grades ( P > 0.05 ). Compared with cardiac function grades I and II, the level of LVEF in patients with myocardial infarction in grades III and IV of cardiac function decreased, while the levels of LVEDD, LVESD, LVESV, and E/A increased ( P < 0.05 ). The levels of serum h-FABP and cTnI in patients with myocardial infarction increased with the increase of cardiac function grades ( P < 0.05 ). Conclusion. Patients with myocardial infarction show high levels of h-FABP and cTnI, and CDE plus the detection of serum h-FABP and cTnI levels can significantly improve the detection accuracy and effectively evaluate the left ventricular function of patients with myocardial infarction, with a certain predictive value for cardiac function grading in myocardial infarction.