左心房大小——心脏淀粉样变性的另一个鉴别特征。
Left atrial size--another differentiator for cardiac amyloidosis.
机构信息
Heart Care Partners, Wesley Hospital, Brisbane, Australia.
出版信息
Heart Lung Circ. 2011 Sep;20(9):574-8. doi: 10.1016/j.hlc.2011.06.002. Epub 2011 Jul 16.
BACKGROUND
The "sparkled" echocardiographic appearance of amyloid has become less visually obvious in the era of harmonic imaging. Significantly dilated atria in the setting of a normal sized ventricle may be another easy visual marker for cardiac amyloidosis.
METHODS
A retrospective analysis of echocardiograms of patients with biopsy-proven cardiac amyloid compared with patients with hypertension was conducted. There were 36 patients in each group, and they were matched for left ventricular wall thickness, as well as age and sex.
RESULTS
Patients with cardiac amyloid had significantly larger atria than the group with hypertension (left atrial areas 29 cm(2) versus 19 cm(2), p<0.001, AUC 0.84, volumes 100 cm(3) versus 55 cm(3), p<0.001, AUC 0.915). A volume of 69 cm(3) produced a specificity and sensitivity of 85% for amyloidosis.
CONCLUSIONS
Atrial dilatation can be used as a visual marker for cardiac amyloidosis. This may be a simple visual method to differentiate this infiltrative cardiomyopathy from left ventricular hypertrophy.
背景
在谐波成像时代，淀粉样变的“闪烁”超声心动图表现变得不那么明显。在心室大小正常的情况下，明显扩大的心房可能是另一个用于诊断心脏淀粉样变性的简单的直观标记物。
方法
对经活检证实的心脏淀粉样变患者的超声心动图与高血压患者进行了回顾性分析。每组各有 36 例患者，这些患者的左心室壁厚度、年龄和性别相匹配。
结果
与高血压组相比，心脏淀粉样变患者的心房明显增大（左心房面积 29 cm²对 19 cm²，p<0.001，AUC 为 0.84；左心房容积 100 cm³对 55 cm³，p<0.001，AUC 为 0.915）。左心房容积 69 cm³时，对淀粉样变性的特异性和敏感性分别为 85%。
结论
心房扩张可作为心脏淀粉样变性的直观标记物。这可能是一种简单的直观方法，可将这种浸润性心肌病与左心室肥厚区分开来。
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