Touze J E, Chauvet J, Ouattara K, Coulibaly A O, Ekra A, Ravinet L, Metras D, Bertrand E
Arch Mal Coeur Vaiss. 1984 Sep;77(9):1006-12.
The echocardiographic, angiographic and haemodynamic evolution of endomyocardial fibrosis (EMF) was assessed in 19 patients: 8 patients with isolated right sided EMF, 3 with predominantly right-sided EMF, and 8 with isolated left sided EMF with mitral regurgitation. Echocardiographic controls were preformed in 16 patients, on average 11.3 months after surgery; angiographic and haemodynamic controls were preformed in 14 patients, on average 14 months after surgery. In isolated or predominantly right-sided EMF, echocardiographic abnormalities of septal motion (paradoxal) disappeared. Although the volume of the right heart chambers decreased, they remained dilated. The syndrome of adiastole disappeared in patients operated early. In left EMF with mitral regurgitation, the M-shaped motion of the septum regressed in the 4 cases in which this abnormality was observed preoperatively. The size of the left heart chambers decreased on post-operative echo and angiographic studies. Left ventricular function returned to normal after surgery. The author underline the differences between right and left-sided EMF with mitral regurgitation. In right-sided EMF the evolution is that of adiastole and surgery should be preformed early because the right ventricular reserve is small. In left-sided EMF with mitral regurgitation, the evolution is that of a valvular lesion with a good postoperative result.
对19例患者的心内膜心肌纤维化(EMF)的超声心动图、血管造影和血流动力学演变情况进行了评估:8例为孤立性右侧EMF,3例以右侧EMF为主,8例为伴有二尖瓣反流的孤立性左侧EMF。16例患者进行了超声心动图检查,平均在术后11.3个月;14例患者进行了血管造影和血流动力学检查,平均在术后14个月。在孤立性或主要为右侧的EMF中,室间隔运动的超声心动图异常(矛盾运动)消失。虽然右心腔容积减小,但仍有扩张。早期手术的患者舒张期综合征消失。在伴有二尖瓣反流的左侧EMF中,术前观察到这种异常的4例患者中,室间隔的M型运动恢复正常。术后超声心动图和血管造影研究显示左心腔大小减小。术后左心室功能恢复正常。作者强调了伴有二尖瓣反流的右侧和左侧EMF之间的差异。在右侧EMF中,演变过程为舒张期病变,手术应早期进行,因为右心室储备较小。在伴有二尖瓣反流的左侧EMF中,演变过程为瓣膜病变,术后效果良好。