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[常规及多普勒超声心动图在右心衰竭鉴别诊断中的应用]

[Conventional and Doppler echocardiography in the differential diagnosis of right heart failure].

作者信息

Josephs W, Odenthal H J, Lenga P, Wiechmann H W

机构信息

Medizinische Univ.-Klinik der Ruhr-Universität Bochum am Marienhospital Herne 1.

出版信息

Bildgebung. 1990;57(1-2):5-10.

PMID:2271817
Abstract

In the differential diagnosis of isolated right heart failure 1- and 2-dimensional echocardiography and Doppler echocardiography have proved to be of an increasing significance. In right ventricular dysplasia associated ventricular arrhythmias and regional abnormalities in wall motion of the right ventricle are characteristic. The evaluation of pulmonary heart disease has been extended by the estimation of pulmonary artery pressure using doppler echocardiography. In isolated right heart infarction, echocardiography can detect regional wall motion abnormalities and potential complications like intracavitary mural thrombi. In addition to pericardial calcification on chest x-ray and "dip and plateau" sign on pressure wave form, the abnormal diastolic hemodynamics can be demonstrated studying motion of interventricular septum and posterior left ventricular wall by echocardiography. Separating patients with restrictive cardiomyopathy may be difficult, if demonstration of the characteristic findings--increase of ventricular wall thickness, small ventricular cavities--is impossible. The evaluation of isolated tricuspid valve diseases has become possible non-invasively by Doppler echocardiography. In the diagnosis of the rare right atrial myxomas 2-D-echocardiography is the method of choice.

摘要

在孤立性右心衰竭的鉴别诊断中,一维和二维超声心动图以及多普勒超声心动图已被证明具有越来越重要的意义。在右心室发育不良中,室性心律失常和右心室壁运动的局部异常是其特征。利用多普勒超声心动图评估肺动脉压力,扩展了对肺心病的评估。在孤立性右心梗死中,超声心动图可检测到局部室壁运动异常和潜在并发症,如心腔内附壁血栓。除了胸部X线片上的心包钙化和压力波形上的“下陷与平台”征外,通过超声心动图研究室间隔和左心室后壁的运动,可显示舒张期血流动力学异常。如果无法显示特征性表现——心室壁厚度增加、心室腔小,区分限制型心肌病患者可能会很困难。通过多普勒超声心动图,已能够对孤立性三尖瓣疾病进行无创评估。在罕见的右心房黏液瘤的诊断中,二维超声心动图是首选方法。

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