Gentille-Lorente Delicia, Salvadó-Usach Teresa
Servicio de Cardiología, Hospital de Tortosa Verge de la Cinta, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tortosa, Tarragona, España.
Servicio de Anatomía patológica, Hospital de Tortosa Verge de la Cinta, Institut d'Investigació Sanitària Pere Virgili (IISPV), Tortosa, Tarragona, España.
Arch Cardiol Mex. 2016 Apr-Jun;86(2):110-22. doi: 10.1016/j.acmx.2016.02.001. Epub 2016 Mar 25.
Sigmoid septum and hypertrophic cardiomyopathy presenting with left ventricular hypertrophy and, although they appear to be different entities, often involve problems in the differential diagnosis. This study was carried out to assess the prevalence and characteristics of the echocardiographic sigmoid septum and its differential findings regarding hypertrophic cardiomyopathy.
Descriptive, observational and prospective study. A total of 1,770 patients were studied by echocardiography. Sigmoid septum (focal and isolated hypertrophy of the basal interventricular septum≥13mm in men and ≥12mm in women, exceeding ≥50% of the median septum thickness) was classified as «Type 1» (≤14mm) and «Type 2» (≥15mm).
There were 59 cases of sigmoid septum (prevalence of 3.3%): 26 (1.5%) patients with type 1 (50% male) and 33 (1.9%) patients with type 2 (72.7% male); there were 25 (1.4%) cases of hypertrophic cardiomyopathy (76% male). The group with type 2 sigmoid septum differed from hypertrophic cardiomyopathy in: was older (73±10.5years; P<.0001), with more hypertension (84.8%; P<.0001), lower glomerular filtering (73.3±21.4ml/min; P=.007), lower repolarization abnormalities (18.2%; P=.004) and Cornell index (in men, 22.2±11mm; P=.041), more diastolic dysfunction (75%; P=.0089) and in ventricular morphology and fibrosis location in magnetic resonance.
Regarding the hypertrophic cardiomyopathy, patients with type 2 sigmoid septum are older and generally hypertensive; otherwise, often they have no clear differences in their clinical, electrocardiographic or echocardiographic characteristics. Therefore, cardiac resonance is helpful in the differential diagnosis.
乙状结肠隔与肥厚型心肌病均表现为左心室肥厚，尽管它们似乎是不同的实体，但在鉴别诊断中常存在问题。本研究旨在评估超声心动图乙状结肠隔的患病率和特征及其与肥厚型心肌病的鉴别结果。
描述性、观察性和前瞻性研究。共对1770例患者进行了超声心动图检查。乙状结肠隔（男性基底室间隔局灶性孤立性肥厚≥13mm，女性≥12mm，超过室间隔厚度中位数的≥50%）分为“1型”（≤14mm）和“2型”（≥15mm）。
有59例乙状结肠隔（患病率为3.3%）：26例（1.5%）为1型患者（50%为男性），33例（1.9%）为2型患者（72.7%为男性）；有25例（1.4%）肥厚型心肌病患者（76%为男性）。2型乙状结肠隔组与肥厚型心肌病在以下方面存在差异：年龄较大（73±10.5岁；P<0.0001），高血压患者更多（84.8%；P<0.0001），肾小球滤过率较低（73.3±21.4ml/分钟；P=0.007），复极异常较低（18.2%；P=0.004）和康奈尔指数（男性为22.2±11mm；P=0.041），舒张功能障碍更多（75%；P=0.0089），以及磁共振成像中的心室形态和纤维化位置。
对于肥厚型心肌病，2型乙状结肠隔患者年龄较大且一般患有高血压；否则，他们在临床、心电图或超声心动图特征方面通常没有明显差异。因此，心脏磁共振成像有助于鉴别诊断。
