Pinar Sopena J, Candell Riera J, San José Laporte A, Bosch Gil J, García del Castillo H, Vilardell Tarres M, Soler Soler J
Servicio de Cardiología, Hospital General Vall d'Hebron, Barcelona.
Rev Esp Cardiol. 1990 Aug-Sep;43(7):450-6.
In order to assess the degree and type of cardiac involvement in patients with sustained hypereosinophilia, we studied by two-dimensional, M-mode echocardiography and Doppler (4 cases) 20 patients distributed into 2 groups. Group I: 10 patients with the idiopathic hypereosinophilic syndrome. Group II: 10 patients with secondary hypereosinophilia. In group I, 6 patients (60%) had echocardiographic abnormalities consistent with the endomyocardial disease: four apical obliteration of right ventricle, three apical obliteration of left ventricle, three endocardial thickening of the left ventricle, three endocardial thickening of the left ventricle posterior wall, one endocardial thickening of the right ventricle free wall, three subvalvular mitral thickening, three subvalvular tricuspid thickening, two pericardial effusion and two protodiastolic septal notch. These corresponded to 2 cases of endomyocardial fibrosis and restriction, as shown by pathological and hemodynamic study. In only 1 patient from group II echocardiographic abnormalities consistent with right apical occupation and tricuspid subvalvular thickening, with mild regurgitation detected by Doppler, were found. It was concluded that echocardiographic abnormalities are common in patients with idiopathic hypereosinophilic syndrome, even in the absence of clinical features. The development of echocardiographic abnormalities in patients with sustained secondary hypereosinophilia is exceptional and is probably related to duration of eosinophilia. Therefore, we think that echo-Doppler is a fundamental investigation for the diagnosis and follow-up of these patients.
为了评估持续性嗜酸性粒细胞增多症患者心脏受累的程度和类型，我们通过二维、M型超声心动图和多普勒检查（4例）对20例患者进行了研究，这些患者分为2组。第一组：10例特发性嗜酸性粒细胞增多综合征患者。第二组：10例继发性嗜酸性粒细胞增多症患者。在第一组中，6例患者（60%）有与心内膜疾病相符的超声心动图异常：4例右心室心尖部闭塞，3例左心室心尖部闭塞，3例左心室心内膜增厚，3例左心室后壁心内膜增厚，1例右心室游离壁心内膜增厚，3例二尖瓣瓣下增厚，3例三尖瓣瓣下增厚，2例心包积液和2例舒张早期室间隔切迹。病理和血流动力学研究显示，这些对应于2例心内膜纤维化和限制型心肌病。在第二组中，仅1例患者发现有与右心室心尖部占位和三尖瓣瓣下增厚相符的超声心动图异常，多普勒检查发现有轻度反流。得出的结论是，特发性嗜酸性粒细胞增多综合征患者即使没有临床特征，超声心动图异常也很常见。持续性继发性嗜酸性粒细胞增多症患者出现超声心动图异常的情况罕见，可能与嗜酸性粒细胞增多的持续时间有关。因此，我们认为超声多普勒检查是这些患者诊断和随访的重要检查手段。
