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孤立性左心室心肌致密化不全的超声心动图特征

Echocardiographic characteristics of isolated left ventricular noncompaction.

作者信息

Fazlinezhad Afsoon, Vojdanparast Mohammad, Sarafan Shadi, Nezafati Pouya

机构信息

Professor, Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

Cardiologist, Cardiovascular Research Center, Mashhad University of Medical Sciences, Mashhad, Iran.

出版信息

ARYA Atheroscler. 2016 Sep;12(5):243-247.

Abstract

BACKGROUND

Although isolated left ventricular noncompaction (ILVNC) has been described almost two decades ago, our knowledge about its diagnosis, presentation, echocardiographic features and clinical outcome is sparse. We aimed to assess the echocardiographic and clinical characteristics of ILVNC in a group of patients referred to our center.

METHODS

Patients who were referred to a tertiary referral center, affiliated with Mashhad University of Medical Sciences, with primary diagnosis of dilated cardiomyopathy underwent comprehensive echocardiographic evaluation. The diagnosis of ILVNC was made based on the presence of two-structural layer in myocardium; ratio of noncompacted to compacted layers more than 2, and excessive trabeculation in the left ventricle.

RESULTS

Final diagnoses of ILVNC were made in 42 patients. Mean age of patients was 32.9 ± 15.6 years (ranging from 9 to 70 years). Females comprised a higher proportion of patients (61.9%) and shortness of breath was the most reported symptom among patients (47.6%). Non-compacted layers were detected in inferior and lateral segments of apex in 97.6% of patients. A total of 26 (61.9%) patients had left ventricle (LV) dysfunction (defined as ejection fraction less than 50%). The only factor that showed significant association with LV dysfunction was the number of affected segments with noncompaction (P = 0.008). Reduced ejection fraction was not associated with either age or sex (P = 0.437 and P = 0.206, respectively).

CONCLUSION

Based on the result of the current study, it can be suggested that apex of the heart is the most common site of noncompaction and increasing numbers of affected segments might be associated with LV dysfunction.

摘要

背景

尽管孤立性左心室心肌致密化不全(ILVNC)在近二十年前就已被描述,但我们对其诊断、表现、超声心动图特征及临床结局的了解仍很匮乏。我们旨在评估转诊至我们中心的一组患者中ILVNC的超声心动图和临床特征。

方法

转诊至与马什哈德医科大学相关的三级转诊中心、初步诊断为扩张型心肌病的患者接受了全面的超声心动图评估。ILVNC的诊断基于心肌中存在两层结构;非致密层与致密层的比例大于2,以及左心室内存在过多的肌小梁。

结果

42例患者最终被诊断为ILVNC。患者的平均年龄为32.9±15.6岁(范围为9至70岁)。女性患者占比更高(61.9%),呼吸急促是患者中最常报告的症状(47.6%)。97.6%的患者在心尖部的下壁和侧壁检测到非致密层。共有26例(61.9%)患者存在左心室(LV)功能障碍(定义为射血分数小于50%)。与LV功能障碍显示出显著关联的唯一因素是非致密化受累节段的数量(P = 0.008)。射血分数降低与年龄或性别均无关联(分别为P = 0.437和P = 0.206)。

结论

基于本研究结果,可表明心尖是心肌致密化不全最常见的部位,受累节段数量的增加可能与LV功能障碍有关。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b9f0/5403019/b7b6038a09e2/ARYA-12-243f1.jpg

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