Matsuno Y, Izumi S, Murakami R, Murakami Y, Kobayashi S, Morioka S, Moriyama K
Fourth Department of Internal Medicine, Shimane Medical University, Izumo.
J Cardiol. 1989 Jun;19(2):627-35.
Mid-ventricular obstruction was evaluated in a case of hypertrophic cardiomyopathy using a real-time two-dimensional Doppler flow imaging system. A 60-year-old woman was referred to our hospital because of oppressive precordial sensation., I-mode echocardiography showed asymmetric septal hypertrophy: thickness of the end-diastolic left ventricular posterior wall was 9 mm, and that of the interventricular septum was 19 mm. However, there was no systolic anterior motion of the mitral apparatus. Doppler color flow imaging showed a mid-left ventricular narrowing in late-systole and a mosaic pattern was depicted from the mid-ventricle to the outflow tract. Continuous wave Doppler echocardiography disclosed a peak velocity of 2.0 m/sec (pressure gradient (PG) = 16 mmHg). In the right ventricular outflow tract, a mosaic pattern was also seen and a peak velocity of 1.5 m/sec was detected (PG = 9 mmHg). These results were nearly identical with the data measured by cardiac catheterization. Thus, it was concluded that intraventricular obstruction of hypertrophic cardiomyopathy is diagnosed by observing the flow image and flow velocities in the ventricle using a real-time two-dimensional Doppler flow imaging system.
使用实时二维多普勒血流成像系统对一例肥厚型心肌病患者的心室中部梗阻情况进行了评估。一名60岁女性因心前区压迫感被转诊至我院。I型超声心动图显示室间隔不对称肥厚：舒张末期左心室后壁厚度为9毫米，室间隔厚度为19毫米。然而，二尖瓣装置无收缩期前向运动。多普勒彩色血流成像显示左心室中部在收缩末期变窄，从中心室到流出道呈现出一种镶嵌样血流模式。连续波多普勒超声心动图显示峰值速度为2.0米/秒（压力阶差（PG）=16毫米汞柱）。在右心室流出道，也可见镶嵌样血流模式，检测到峰值速度为1.5米/秒（PG = 9毫米汞柱）。这些结果与心导管检查测得的数据几乎一致。因此，得出结论，使用实时二维多普勒血流成像系统观察心室中的血流图像和血流速度可诊断肥厚型心肌病的室内梗阻。
