Saitoh M, Kasagi S, Miyakoda H, Kotake H, Mashiba H
First Department of Internal Medicine, Tottori University School of Medicine, Yonago, Japan.
No To Shinkei. 1991 Jan;43(1):37-41.
Two-dimensional echocardiography and Doppler echocardiography were performed in 19 patients with Duchenne muscular dystrophy for evaluating right ventricular overload and left ventricular function. Five of 19 patients were treated with mechanical ventilation. We defined right ventricular overload as right ventricular enlargement and the presence of paradoxical ventricular septal motion. The right ventricular dimensions in patients with mechanical ventilation were significantly larger than in patients without mechanical ventilation (p less than 0.01). All the patients with and without mechanical ventilation showed no significant right ventricular enlargement and none of them showed paradoxical ventricular septal motion. As for left ventricular function, there were no significant differences in the incidence of regional or diffuse wall motion abnormalities between two groups. However, the left ventricular fractional shortening was significantly lower in patients with mechanical ventilation than in patients without it (p less than 0.05), and the incidence of mitral regurgitation was significantly higher in the former than in the latter (p less than 0.01). Our findings suggest that right ventricular function is preserved even in patients with respiratory failure by appropriate respiratory treatment. Therefore, we should give attention to the progression of left ventricular dysfunction in long term prognosis.
对19例杜氏肌营养不良患者进行了二维超声心动图和多普勒超声心动图检查，以评估右心室负荷过重和左心室功能。19例患者中有5例接受了机械通气治疗。我们将右心室负荷过重定义为右心室扩大和室间隔矛盾运动的存在。接受机械通气治疗的患者右心室尺寸显著大于未接受机械通气治疗的患者（p<0.01）。所有接受和未接受机械通气治疗的患者均未出现明显的右心室扩大，且均未出现室间隔矛盾运动。至于左心室功能，两组之间局部或弥漫性室壁运动异常的发生率无显著差异。然而，接受机械通气治疗的患者左心室缩短分数显著低于未接受机械通气治疗的患者（p<0.05），且前者二尖瓣反流的发生率显著高于后者（p<0.01）。我们的研究结果表明，即使是呼吸衰竭患者，通过适当的呼吸治疗，右心室功能也能得以保留。因此，在长期预后中我们应关注左心室功能障碍的进展。
