Drüeke T, Le Pailleur C, Meilhac B, Koutoudis C, Zingraff J, Di Matteo J, Crosnier J
Br Med J. 1977 Feb 5;1(6057):350-3. doi: 10.1136/bmj.1.6057.350.
Five uraemic patients who developed progressive cardiac failure with clinical evidence of congestive cardiomyopathy at the start or during haemodialysis treatment were studied. The diagnosis of cardiomyopathy, for which there was no apparent cause, was confirmed by angiocardiographic and haemodynamic studies. These showed a significant increase in left ventricular end-diastolic volume over normal values obtained in 12 patients without uraemia. The mean velocity of myocardial fibre shortening was significantly decreased, as was the index of normalised rigidity. Three of the five patients presented the complete picture of the disease. The other two also had considerable ventricular dilatation and a decreased index of normalised rigidity but normal ejection fraction and only moderately decreased myocardial contractility indices. This suggests that there may be primary involvement of normalised heart muscle rigidity followed by secondary changes in myocardial contractility in uraemic patients with congestive cardiomyopathy.
对5例尿毒症患者进行了研究，这些患者在血液透析治疗开始时或治疗期间出现进行性心力衰竭，并伴有充血性心肌病的临床证据。通过心血管造影和血流动力学研究证实了心肌病的诊断，且无明显病因。研究显示，与12例无尿毒症患者的正常值相比，左心室舒张末期容积显著增加。心肌纤维缩短的平均速度显著降低，标准化僵硬度指数也降低。5例患者中有3例呈现出该病的全貌。另外2例也有明显的心室扩张和标准化僵硬度指数降低，但射血分数正常，心肌收缩力指标仅轻度降低。这表明，在患有充血性心肌病的尿毒症患者中，可能首先是标准化心肌僵硬度受到影响，随后心肌收缩力发生继发性改变。
