Shabetai R
University of California, San Diego.
Postgrad Med J. 1992;68 Suppl 1:S47-51.
The topic of restrictive cardiomyopathy remains controversial for many reasons. The term cardiomyopathy is unfortunately sometimes used interchangeably with diastolic heart failure. Furthermore, diastolic heart failure is sometimes linked with other causes of diastolic dysfunction such as hypertrophic cardiomyopathy and mitral valve disease. Restrictive cardiomyopathy is a clinical entity of primary or secondary myocardial disease presenting a picture that closely simulates that of constrictive pericarditis. In the majority of cases the correct diagnosis can be arrived at following a careful paradigm that begins with history and may end with endomyocardial biopsy. Many of the old teachings about how to distinguish restrictive cardiomyopathy from constrictive pericarditis have not held up with time and clinical experience: in particular equal diastolic pressures on both sides of the heart are compatible with either restrictive cardiomyopathy or constrictive pericarditis.
由于多种原因，限制型心肌病这一主题仍存在争议。遗憾的是，“心肌病”一词有时与舒张性心力衰竭互换使用。此外，舒张性心力衰竭有时与舒张功能障碍的其他原因相关，如肥厚型心肌病和二尖瓣疾病。限制型心肌病是一种原发性或继发性心肌疾病的临床实体，其表现与缩窄性心包炎极为相似。在大多数情况下，通过从病史开始并可能以内膜心肌活检结束的仔细模式，可做出正确诊断。许多关于如何区分限制型心肌病和缩窄性心包炎的旧有学说，随着时间推移和临床经验已不再成立：特别是心脏两侧舒张压力相等既可见于限制型心肌病，也可见于缩窄性心包炎。
