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孤立性左心室心肌致密化不全

[Isolated left ventricular non-compaction].

作者信息

Aragona Pierluigi, Badano Luigi Paolo, Pacileo Giuseppe, Pino Giuseppe Paolo, Sinagra Gianfranco, Zachara Elisabetta

机构信息

U.O.C. di Cardiologia-UTIC, Ospedale Civile G. Chidichimo, ASL 3 della Sibaritide, Trebisacce (CS), Roma.

出版信息

Ital Heart J Suppl. 2005 Oct;6(10):649-59.

Abstract

Isolated left ventricular noncompaction is a genetically heterogeneous congenital disorder characterized by an altered structure of the myocardial wall. This cardiomyopathy is thought to be due to an arrest of intrauterine compaction of the myocardial fibers in the absence of any other structural heart disease. Noncompaction of the left ventricular myocardium is an uncommon finding and remains frequently overlooked even by experienced echocardiographers. However, a correct diagnosis of noncompaction has important implications due to the possible association with other cardiac abnormalities and/or muscle disorders, progressive left ventricular dysfunction, risk of thromboembolism, and life-threatening arrhythmias. Furthermore, because of the familial association described with ventricular noncompaction, screening with echocardiography of first relatives is recommended. Since echocardiography is the diagnostic technique of choice, missed diagnoses may be due to nonoptimal imaging of the lateral and apical myocardium, and/or insufficient disease awareness by echocardiographers. To increase awareness of left ventricular noncompaction, the present paper reviews embryology, genetics, clinical features and pathophysiology, diagnosis, treatment and prognosis of patients affected by isolated left ventricular noncompaction.

摘要

孤立性左心室心肌致密化不全是一种具有遗传异质性的先天性疾病,其特征为心肌壁结构改变。这种心肌病被认为是由于在没有任何其他结构性心脏病的情况下,心肌纤维在子宫内的致密化过程停滞所致。左心室心肌致密化不全是一种不常见的发现,即使是经验丰富的超声心动图医生也常常忽视。然而,由于可能与其他心脏异常和/或肌肉疾病、进行性左心室功能障碍、血栓栓塞风险以及危及生命的心律失常相关,正确诊断致密化不全具有重要意义。此外,由于已描述心室致密化不全存在家族关联,建议对一级亲属进行超声心动图筛查。由于超声心动图是首选的诊断技术,漏诊可能是由于对侧壁和心尖心肌的成像不理想,和/或超声心动图医生对该疾病的认识不足。为提高对左心室心肌致密化不全的认识,本文综述了孤立性左心室心肌致密化不全患者的胚胎学、遗传学、临床特征、病理生理学、诊断、治疗及预后。

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