Hall R J
Eur Heart J. 1983 Apr;4(4):230-7. doi: 10.1093/oxfordjournals.eurheartj.a061453.
Thirty-nine patients with severe cardiac failure and a previous transmural myocardial infarct were studied prospectively to assess the ability of M-mode echocardiography to detect resectable left ventricular aneurysms. Subsequent angiography showed an aneurysm in 23 patients and diffuse left ventricular damage in 16. Nine (57%) of the patients without aneurysm had either left ventricular end-systolic dimensions in excess of 6 cm combined with reduced contraction of the base of the left ventricle (fractional shortening of the level of the mitral valve less than 20%), or gross reduction of contraction (fractional shortening less than 15%) regardless of left ventricular dimension. These abnormalities did not occur in any patient with an aneurysm. In 21 (91%) of the patients with a left ventricular aneurysm its presence was correctly predicted either by fractional shortening in excess of 20% (16 patients) or gross delay of mitral valve opening (greater than 80 ms 16 patients). In one patient without an aneurysm, fractional shortening was greater than 20% and thus incorrectly suggested the presence of aneurysm. Only 39% of aneurysms were directly visualized. Therefore M-mode echocardiography can correctly rule out the diagnosis in over 50% of patients without an aneurysm and strongly suggest the possibility in over 90% of patients with one.
对39例严重心力衰竭且既往有透壁性心肌梗死的患者进行了前瞻性研究，以评估M型超声心动图检测可切除左心室室壁瘤的能力。随后的血管造影显示，23例患者有室壁瘤，16例有弥漫性左心室损害。在无室壁瘤的患者中，9例（57%）要么左心室收缩末期内径超过6 cm，同时左心室底部收缩减弱（二尖瓣水平的缩短分数小于20%），要么无论左心室大小如何，收缩明显减弱（缩短分数小于15%）。这些异常在任何有室壁瘤的患者中均未出现。在21例（91%）有左心室室壁瘤的患者中，通过超过20%的缩短分数（16例患者）或二尖瓣开放明显延迟（大于80毫秒，16例患者）正确预测了室壁瘤的存在。在1例无室壁瘤的患者中，缩短分数大于20%，因此错误地提示存在室壁瘤。只有39%的室壁瘤能直接显示。因此，M型超声心动图能在超过50%无室壁瘤的患者中正确排除诊断，并在超过90%有室壁瘤的患者中强烈提示其可能性。
