目的应用冠状动脉CTA评估肥厚 型心肌病伴发稳定性心绞痛患者冠状动 脉狭窄情况。方法 回顾性分析2011.6- 2014.6间55例稳定性心绞痛症状的肥厚型 心肌病患者，选取无肥厚型心肌病但冠状 动脉CTA表现为冠状动脉狭窄(6个月内)患 者55例作为对照组。所有病例由2名经验 丰富放射医师采用双盲法进行独立阅片， 管腔狭窄>70%为严重冠状动脉狭窄，管腔 <50%为轻度冠状动脉狭窄，管腔50-70%为 中度冠状动脉狭窄。结果 肥厚型心肌病 患者中度或重度冠状动脉狭窄发生率明显 低于对照组(P<0.01)，同时肥厚型心肌病 患者单支中度冠状动脉狭窄发生率明显 低于对照组(P<0.01)。肥厚型心肌病患者 左前降支中度或重度狭窄明显低于对照 组(P=0.02)。肥厚型心肌病组平均深度 是5.0±2.4mm、平均宽度是27.5±13.4 mm；对照组平均深度为2.7±1.2mm平均宽 度为8.8±3.4mm，P<0.01。结论 冠状动 脉CTA应成为检查肥厚型心肌病患者表现 为稳定性心绞痛是否冠状动脉狭窄首选检 查方法。

Objective To assessment of patients with HCM and stable anginal symptoms incidence of epicardial coronary artery. Methods Retrospective analysis 2011.6-2014.6 55 hypertrophic cardiomyopathy patientsAge-and gender-matched patients without HCM referred for CCTA because of similar symptoms over a 6-month period were used as controls. The coronary arteries were evaluated independently by 2 blinded observers, and any luminal narrowing was scored quantitatively as follows:>70% severe; 50%- 70% moderate; <50% mild; and none. Results the incidence of moderate or severe coronaryartery stenosis was significantly lower in patients with HCM compared to the control group (P<0.0001). Also,severe stenosis alone was significantly lower in the HCM group compared to controls (P<0.0001). the incidence of moderate or severe LAD stenosis was significantlylower in the HCM patients than in the controls (P<0.002). Conclusion CCTA should be considered as a first-line investigation for HCM patients with stable anginal symptoms in epicardial coronary artery stenosis