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[主动脉瓣下狭窄的超声心动图诊断]

[Echocardiographic diagnosis of aortic subvalvular stenosis].

作者信息

Liakishev A A, Gasilin V S, Shevchenko O P

出版信息

Kardiologiia. 1978 May;18(5):71-5.

PMID:149876
Abstract

Seventeen patients with idiopathic hypertrophic subaortic stenosis were examined by the M-method of echocardiography with the "Ekoline 20-A" apparatus. In all patients the interventricular septum was hypertrophied asymmetrically within limits of 15-22 mm, 17 mm on the average. The ratio of the thickness of the interventricular septum and that of the left-ventricular posterior wall amounted to 1.4-1.9, 1.6 on the average. The amplitude of movements of the interventricular septum did not exceed 3 mm and the degree of its systolic thickening ranged between 0 and 28%, being 13% on the average. In 16 patients there was anomalous systolic movement of the anterior mitral cusp to the front taking up an average of 56% of the time of the left-ventricular systole. The rate of early diastolic closure of the anterior mitral cusp was diminished from 37 to 58 mm/sec. Midsystolic closure of the aortic valve coinciding with maximum systolic murmur was noted in 9 patients. The left atrium was enlarged in 5 patients, one of whom developed atrial fibrillation. Intensification of symptoms of left-ventricular obstruction in amyl nitrite inhalation and in the first postextrasystole complex was noted. Treatment with propranolol in a dose of 60-120 mg for 3 to 9 months caused no changes in the echocardiogram.

摘要

采用“Ekoline 20 - A”型超声心动图仪的M型超声心动图对17例特发性肥厚性主动脉瓣下狭窄患者进行了检查。所有患者的室间隔均呈不对称肥厚,厚度在15 - 22mm之间,平均为17mm。室间隔厚度与左心室后壁厚度之比为1.4 - 1.9,平均为1.6。室间隔运动幅度不超过3mm,其收缩期增厚程度在0%至28%之间,平均为13%。16例患者二尖瓣前叶在收缩期有异常向前运动,平均占左心室收缩期时间的56%。二尖瓣前叶舒张早期关闭速度从37降至58mm/秒。9例患者在主动脉瓣收缩中期关闭时出现最大收缩期杂音。5例患者左心房增大,其中1例发生心房颤动。亚硝酸异戊酯吸入时及早搏后第一个复合波时左心室梗阻症状加重。给予60 - 120mg普萘洛尔治疗3至9个月,超声心动图无变化。

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