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[储存和神经肌肉疾病中的超声心动图]

[Echocardiography in storage and neuromuscular disorders].

作者信息

Stöllberger C, Finsterer J

机构信息

2. Medizinische Abteilung, Krankenanstalt Rudolfstiftung.

出版信息

Wien Klin Wochenschr. 2001 Jun 15;113(11-12):408-15.

Abstract

Storage disorders and neuromuscular disorders may lead to cardiac involvement which can be visualized by echocardiography. In storage disorders like hypothyroidism, haemochromatosis, amyloidosis, mucopolysaccharidosis and Fabry's disease, myocardial thickening and systolic dysfunction can be found. In amyloidosis, atrial enlargement and abnormal texture of the myocardium are additional findings. In advanced haemochromatosis all cardiac chambers may be dilated. In hypothyroidism and amyloidosis, a pericardial effusion can be present. In haemochromatosis and amyloidosis, a restrictive filling pattern may be detected using Doppler-sonography. Mucopolysaccharidosis and Gaucher's disease may lead to aortic and mitral stenosis. In neuromuscular disorders like glycogenosis, mitochondriopathy and myotonic dystrophy, myocardial thickening and systolic dysfunction are found, in spinal muscular atrophy myocardial thickening and in muscular dystrophy Becker/Duchenne systolic dysfunction. An abnormal myocardial texture may be present in glycogenosis, isolated left ventricular abnormal trabeculation (ILVAT) in mitochondriopathy, myotonic dystrophy and muscular dystrophy Becker/Duchenne. Using Doppler-sonography an impaired relaxation of the left ventricle may be detected in mitochondriopathy, myotonic dystrophy and spinal muscular atrophy. Most of these echocardiographic findings are unspecific and may be overlooked, especially if the storage or neuromuscular disorder is yet unknown. Establishing a correct diagnosis is important, since healing or functional improvement is possible in many of these disorders.

摘要

贮积病和神经肌肉疾病可能导致心脏受累,这可通过超声心动图观察到。在诸如甲状腺功能减退症、血色素沉着症、淀粉样变性、黏多糖贮积症和法布里病等贮积病中,可发现心肌增厚和收缩功能障碍。在淀粉样变性中,还可发现心房扩大和心肌质地异常。在晚期血色素沉着症中,所有心腔可能扩张。在甲状腺功能减退症和淀粉样变性中,可能存在心包积液。在血色素沉着症和淀粉样变性中,使用多普勒超声检查可能检测到限制性充盈模式。黏多糖贮积症和戈谢病可能导致主动脉瓣和二尖瓣狭窄。在诸如糖原贮积病、线粒体病和强直性肌营养不良等神经肌肉疾病中,可发现心肌增厚和收缩功能障碍,在脊髓性肌萎缩症中可发现心肌增厚,在贝克尔/杜兴肌营养不良症中可发现收缩功能障碍。在糖原贮积病中可能存在心肌质地异常,在线粒体病、强直性肌营养不良症以及贝克尔/杜兴肌营养不良症中可发现孤立性左心室异常肌小梁(ILVAT)。使用多普勒超声检查,在线粒体病、强直性肌营养不良症和脊髓性肌萎缩症中可能检测到左心室舒张功能受损。这些超声心动图表现大多缺乏特异性,可能被忽视,尤其是在贮积病或神经肌肉疾病尚未明确时。正确诊断很重要,因为在许多这类疾病中有可能实现治愈或功能改善。

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