Blomström-Lundqvist C, Beckman-Suurküla M, Wallentin I, Jonsson R, Olsson S B
Medical Department I, Sahlgren's Hospital, Gothenburg, Sweden.
Eur Heart J. 1988 Dec;9(12):1291-302. doi: 10.1093/oxfordjournals.eurheartj.a062446.
Twenty patients with arrhythmogenic right ventricular dysplasia (ARVD) and 20 healthy volunteers underwent cross-sectional echocardiographic examination for the assessment of ventricular dimensions and wall motion. Right ventricular cavity diameters and wall segments were selected from the inflow and outflow tracts and the right ventricular body. The measurement error for measuring cavity dimensions was low throughout and the reproducibility of wall motion scoring was high in both the normal subjects and the patients. All except one patient had increased dimensions and/or abnormal wall motion in the right ventricle. The right ventricular inflow tract was dilated in nine patients, the outflow tract in 11 patients and the short- or long-axis diameters of the right ventricular body were increased in seven patients. Right ventricular wall motion abnormalities, being the most frequent finding, ranged from mild hypokinesia only to dyskinesia or sacculations, and were fairly evenly distributed among the segments studied. Left ventricular abnormalities, found in eight patients, were generally mild. Cross-sectional echocardiography thus provides highly reproducible measurements of right ventricular size and contraction patterns even in patients with wall shape deformities, and is therefore a feasible non-invasive method for the evaluation of right-sided myocardial abnormalities in patients with ARVD. The diagnostic accuracy of this technique warrants further clarification.
20例致心律失常性右室心肌病(ARVD)患者和20名健康志愿者接受了横断面超声心动图检查,以评估心室大小和壁运动。从流入道、流出道和右心室主体选取右心室腔直径和壁段。测量腔径的误差始终较低,正常受试者和患者的壁运动评分的可重复性均较高。除1例患者外,所有患者的右心室尺寸均增大和/或壁运动异常。9例患者右心室流入道扩张,11例患者流出道扩张,7例患者右心室主体的短轴或长轴直径增加。右心室壁运动异常是最常见的发现,范围从仅轻度运动减弱到运动障碍或囊状膨出,并且在所研究的节段中分布相当均匀。8例患者发现左心室异常,一般较轻。因此,即使在壁形状畸形的患者中,横断面超声心动图也能提供高度可重复的右心室大小和收缩模式测量,因此是评估ARVD患者右侧心肌异常的一种可行的非侵入性方法。该技术的诊断准确性有待进一步明确。