Zhao Yanyan, Lin Shibin, Wu Jingjing, Lai Jineng, Li Lan
Department of Ultrasound, The First Affiliated Hospital of Hainan Medical University Haikou 570102, Hainan, China.
Am J Transl Res. 2021 May 15;13(5):5200-5207. eCollection 2021.
To investigate the clinical application values of electrocardiogram (ECG) combined with ultrasound cardiogram (UCG) in the differential diagnosis of cardiomyopathy.
A total of 120 patients with cardiomyopathy who were admitted to our hospital were randomly divided into the dilated cardiomyopathy (DCM) group (60 cases) and the ischemic cardiomyopathy (ICM) group (60 cases). Both groups were examined using ECG combined with UCG. The ultrasonic values (aorta, LADI, LVDd, LVESD, RVID, SV, LVEF, LVET, EPSS, E/A, RV6, RV6/RMAX), morphological changes (thin and round left ventricular apex, spherical left ventricle, arch-shaped left ventricle, segmental wall-motion abnormalities (SWMAs), diffuse wall motion abnormalities (DWMAs), paradoxical ventricular wall motion) and heart valve regurgitation (aortic valve, mitral valve, tricuspid valve, pulmonary valve) were compared and analyzed.
The degree of chamber enlargement in the DCM group was remarkably higher than that in the ICM group, but the degree of LVEF and aortic enlargement were significantly lower than those in the ICM group (<0.05). The detection rates of spherical left ventricle and DWMAs in the DCM group were 60.00% and 100.00% respectively, which was significantly higher than those (6.66% and 40.00%) of the ICM group (<0.05), but the detection rates of thin and round left ventricular apex, arch-shaped left ventricle, SWMAs, and paradoxical ventricular wall motion were 53.33%, 66.66%, 46.66% and 20.00% respectively in the ICM group, which were markedly higher than those in the DCM group. The incidence rates of aortic valve, mitral valve, tricuspid valve and pulmonary valve in the DCM group were 66.66%, 100.00%, 46.66% and 76.66%, which were notably higher than those (36.66%, 93.33%, 26.66% and 40.00%) in the ICM group (<0.05).
ECG combined with UCG examination can effectively improve the judgment rate and diagnosis accuracy of cardiomyopathy. Due to its high safety, ECG combined with UCG examination is worthy of clinical promotion and application.
探讨心电图（ECG）联合超声心动图（UCG）在心肌病鉴别诊断中的临床应用价值。
选取我院收治的120例心肌病患者，随机分为扩张型心肌病（DCM）组（60例）和缺血性心肌病（ICM）组（60例）。两组均采用ECG联合UCG进行检查。比较分析超声值（主动脉、左房内径、左室舒张末内径、左室收缩末内径、右室内径、每搏输出量、左室射血分数、左室射血时间、左室后壁舒张末期厚度、E/A比值、右室流出道内径、右室流出道内径与主动脉内径比值）、形态学改变（左室心尖部变薄圆钝、左室球形、左室呈圆拱形、节段性室壁运动异常、弥漫性室壁运动异常、矛盾运动）及心脏瓣膜反流（主动脉瓣、二尖瓣、三尖瓣、肺动脉瓣）情况。
DCM组心腔扩大程度显著高于ICM组，但左室射血分数及主动脉增宽程度显著低于ICM组（<0.05）。DCM组左室球形及弥漫性室壁运动异常检出率分别为60.00%和100.00%，显著高于ICM组的6.66%和40.00%（<0.05），而ICM组左室心尖部变薄圆钝、左室呈圆拱形、节段性室壁运动异常及矛盾运动检出率分别为53.33%、66.66%、46.66%和20.00%，明显高于DCM组。DCM组主动脉瓣、二尖瓣、三尖瓣及肺动脉瓣反流发生率分别为66.66%、100.00%、46.66%和76.66%，显著高于ICM组的36.66%、93.33%、26.66%和40.00%（<0.05）。
ECG联合UCG检查可有效提高心肌病的判断率及诊断准确性。因其安全性高，ECG联合UCG检查值得临床推广应用。
