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二维超声心动图对儿童扩张型心肌病的评估

Two-dimensional echocardiographic evaluation of dilated cardiomyopathy in children.

作者信息

Goldberg S J, Valdes-Cruz L M, Sahn D J, Allen H D

出版信息

Am J Cardiol. 1983 Dec 1;52(10):1244-8. doi: 10.1016/0002-9149(83)90581-7.

Abstract

This study examines and quantitates left ventricular (LV) short-axis 2-dimensional (2-D) echocardiograms of 16 normal control subjects and 19 patients who presented with clinical features suggestive of myocarditis leading to severe myocardiopathy. Of the 19 patients, 8 died or had cardiac transplantation: 9 were studied in the chronic phase and 10 in the acute phase. The endocardial surface of the LV short-axis image was digitized at chordal level at end-diastole and end-systole. Digitized traces in systole and diastole were superimposed. The cavity area of systole and diastole was determined and expressed as the percent systolic area reduction ratio. In the control subjects, the left ventricles were round in systole and diastole, contracted concentrically, and had a mean percent systolic area reduction of 53% (range 43 to 67). The left ventricle was not round in systole in the patients with myocarditis, and in 15, only the ventricular septum contracted significantly. Three patients had nonconcentric contraction, and regional contraction was more difficult to judge. The systolic area reduction ratio for the patients was 11% (range 1 to 33), with no overlap with control subjects (p less than 0.001). Our results suggest that myocarditis more severely affects the LV free wall than the septum. In chronic patients, LV contraction remained markedly impaired. Quantitative evaluation of short-axis 2-D echocardiograms is a useful and sensitive technique for assessing damage due to presumed myocarditis.

摘要

本研究对16名正常对照者和19名有提示心肌炎导致严重心肌病临床特征的患者的左心室(LV)短轴二维(2-D)超声心动图进行了检查和定量分析。在这19名患者中,8人死亡或接受了心脏移植;9人在慢性期接受研究,10人在急性期接受研究。在舒张末期和收缩末期,将LV短轴图像的心内膜表面在腱索水平进行数字化处理。将收缩期和舒张期的数字化轨迹叠加。确定收缩期和舒张期的腔面积,并表示为收缩期面积减少百分比。在对照者中,左心室在收缩期和舒张期均呈圆形,呈同心收缩,平均收缩期面积减少百分比为53%(范围43%至67%)。心肌炎患者的左心室在收缩期不是圆形,在15例中,只有室间隔明显收缩。3例有非同心收缩,区域收缩更难判断。患者的收缩期面积减少率为11%(范围1%至33%),与对照者无重叠(p<0.001)。我们的结果表明,心肌炎对左心室游离壁的影响比对室间隔的影响更严重。在慢性患者中,左心室收缩仍明显受损。短轴二维超声心动图的定量评估是评估疑似心肌炎所致损害的一种有用且敏感的技术。

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