Kasper W, Meinertz T, Henkel B, Eissner D, Hahn K, Hofmann T, Zeiher A, Just H
Am Heart J. 1986 Dec;112(6):1284-90. doi: 10.1016/0002-8703(86)90361-3.
Echocardiographic studies were performed in 105 patients with acute and recurrent pulmonary emboli. Pulmonary embolism was confirmed by pulmonary angiography (n = 48), autopsy (n = 6), and lung perfusion scintigraphy (n = 51). Seventy of 93 patients (75%) displayed a dilated right ventricle, 38 of 91 patients (42%) had reduced left ventricular cavity dimension, 41 of 82 patients (50%) had a decreased EF slope of the mitral valve, and 78 of 101 patients (77%) showed dilatation of the right pulmonary artery. The motion of the interventricular septum was abnormal in 41 of 93 patients (44%). Right-sided thrombi were seen in 13 patients within the right pulmonary artery (n = 11) and in the right ventricle (n = 3); in one patient they were found in the superior vena cava, in the innominate vein, and the right atrium. Two patients suffered from right-sided endocarditis. Thus echocardiographic changes were frequently found in patients with proved pulmonary emboli. The echocardiographic findings of right-sided cardiac and pulmonary artery abnormalities indicate hemodynamically active pulmonary emboli.
对105例急性和复发性肺栓塞患者进行了超声心动图研究。肺栓塞通过肺血管造影(n = 48)、尸检(n = 6)和肺灌注闪烁扫描(n = 51)得以确诊。93例患者中有70例(75%)出现右心室扩张,91例患者中有38例(42%)左心室腔径减小,82例患者中有41例(50%)二尖瓣EF斜率降低,101例患者中有78例(77%)显示右肺动脉扩张。93例患者中有41例(44%)室间隔运动异常。在13例患者中,右侧血栓见于右肺动脉内(n = 11)和右心室内(n = 3);1例患者的血栓见于上腔静脉、无名静脉和右心房。2例患者患有右侧心内膜炎。因此,在已证实的肺栓塞患者中经常发现超声心动图改变。右侧心脏和肺动脉异常的超声心动图表现提示血流动力学活跃的肺栓塞。