Mori Kazuhiro, Edagawa Takuji, Inoue Miki, Nii Masaki, Nakagawa Ryuji, Takehara Yuka, Kuroda Yasuhiro, Tatara Katsunori
Department of Pediatrics, School of Medicine, University of Tokushima, Tokushima-city, Japan.
J Am Soc Echocardiogr. 2004 Apr;17(4):322-9. doi: 10.1016/j.echo.2003.12.016.
Myocardial velocity gradient and wall-thickening velocity were measured in the interventricular septum and left ventricular posterior wall (LVPW) by color-coded M-mode Doppler tissue echocardiography in patients with Duchenne's progressive muscular dystrophy (DMD) with a normal shortening fraction (n = 14) and age-matched control subjects (n = 40). In the LVPW, peak myocardial velocity gradients during systole and early diastole were significantly lower for patients with DMD than in control subjects (P <.0005, and P <.0001, respectively). Peak myocardial wall-thickening velocities of the LVPW during systole and early diastole were also lower for patients with DMD (P <.0005 and P <.0001, respectively). Mitral peak atrial to early filling velocity ratio was not significantly different between the 2 groups. The cut-off values of peak myocardial velocity gradients and wall-thickening velocities of the LVPW during early diastole for differentiation between patients with DMD and control subjects were -5.8/s and -6.0 cm/s, respectively (sensitivity/specificity: 93%/93% and 93%/85%, respectively). In conclusion, wall thinning during early diastole is frequently abnormal in patients with DMD, even when conventional echocardiographic findings are normal.
采用彩色编码M型多普勒组织超声心动图,对射血分数正常的杜氏进行性肌营养不良症(DMD)患者(n = 14)和年龄匹配的对照受试者(n = 40)的室间隔和左心室后壁(LVPW)进行心肌速度梯度和心肌增厚速度测量。在LVPW中,DMD患者收缩期和舒张早期的心肌速度峰值梯度显著低于对照受试者(分别为P <.0005和P <.0001)。DMD患者LVPW收缩期和舒张早期的心肌增厚速度峰值也较低(分别为P <.0005和P <.0001)。两组之间二尖瓣心房峰值与早期充盈速度比值无显著差异。舒张早期LVPW心肌速度峰值梯度和心肌增厚速度区分DMD患者和对照受试者的截断值分别为-5.8/s和-6.0 cm/s(敏感性/特异性分别为93%/93%和93%/85%)。总之,即使传统超声心动图检查结果正常,DMD患者舒张早期心肌变薄也常出现异常。