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原发性心肌病的左心室腔几何形态学:计算机解剖学研究的新发现。

Left ventricular chamber geometry in cardiomyopathies: insights from a computerized anatomical study.

机构信息

Heart Institute (InCor) do Hospital das Clínicas da Faculdade de Medicina, Serviço de Cirurgia Toracica, Universidade de São Paulo, Av. Doutor Enéas de Carvalho Aguiar, 44, 5° andar, bloco II, sala 7, 04503-000, São Paulo, SP, Brazil.

出版信息

ESC Heart Fail. 2018 Jun;5(3):355-364. doi: 10.1002/ehf2.12261. Epub 2018 Feb 21.

Abstract

AIMS

Some authors have hypothesized that left ventricular chamber dilatation in ischaemic and idiopathic cardiomyopathies results in spherical transformation. Aiming to characterize how this transformation occurs, a study was performed by comparing normal and dilated specimens regarding sphericity and proportionality in left heart chambers. It is important to provide data for the development of therapeutic strategies in these diseases.

METHODS AND RESULTS

An anatomical study was performed by comparing normal (n = 10), ischaemic (n = 15), and idiopathic (n = 18) dilated human cardiomyopathic specimens regarding left ventricular chambers and their segmental proportionality to normal hearts. It was performed by capturing and processing images with proper software in three different levels of left ventricular chamber (basal, equatorial, and apical). These obtained data were analysed based on sphericity and proportionality by two dedicated indexes. Spherical shape: Calculated segmental indexes showed that dilated specimens were not spherical because they were smaller than as expected for a spherical shape (all values were <70% of a perfect sphere). Proportionality: There was no difference between basal index perimeters among groups, but apical index was lower in dilated specimens than in normal hearts, and so dilatation was not proportional to normal hearts.

CONCLUSIONS

Left ventricular chambers of anatomical specimens with dilated cardiomyopathies did not display a spherical shape and were not proportional to normal hearts.

摘要

目的

一些作者假设缺血性和特发性心肌病中的左心室腔扩张会导致球形转化。为了描述这种转化是如何发生的,我们比较了正常和扩张的标本,以研究左心腔的球形度和比例。为这些疾病的治疗策略的发展提供数据是很重要的。

方法和结果

通过比较正常(n=10)、缺血性(n=15)和特发性(n=18)扩张性人类心肌病标本的左心室腔及其与正常心脏的节段比例,进行了一项解剖学研究。通过在左心室腔的三个不同水平(基底、赤道和心尖)用适当的软件捕捉和处理图像来进行。根据球形度和比例性,用两个专用指标对这些获得的数据进行分析。球形度:计算的节段性指标显示,扩张的标本不是球形的,因为它们比预期的球形小(所有值都低于完美球体的 70%)。比例性:各组之间的基底指数周长没有差异,但扩张标本的心尖指数低于正常心脏,因此扩张与正常心脏不成比例。

结论

扩张性心肌病的解剖标本的左心室腔没有呈现出球形,也与正常心脏不成比例。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/6841/5933952/badd1261300b/EHF2-5-355-g001.jpg

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