Daniel W, Rathsack P, Walpurger G, Kahle A, Gisbertz R, Schmitz J, Lichtlen P R
Br Heart J. 1980 Jan;43(1):38-44. doi: 10.1136/hrt.43.1.38.
M-mode echocardiographic studies were performed in 11 patients, most of them adults, with Ebstein's anomaly of the tricuspid valve, proven by cardiac catheterisation. Simultaneous recordings of the tricuspid and mitral valves were obtained in all cases, the transducer position being outside the left midclavicular line in seven patients. Tricuspid valve closure followed mitral valve closure in all cases, with an interval ranging between 0.04 and 0.14 s. Since, in more than 8500 routine echocardiographic studies a valve closure interval between 0.09 and 0.12 s was seen in only one patient without Ebstein's anomaly, an interval of 0.065 s or more should be regarded as diagnostic of Ebstein's disease; however, an interval shorter than 0.065 s does not exclude this diagnosis. In all patients a paradoxical septal movement was found. Two patients showed an atypical three-peaked diastolic pattern of movement of the anterior tricuspid leaflet and one patient also showed mitral valve prolapse. Pathological tricuspid valve closure delay, shown by echocardiography, makes it possible to diagnose Ebstein's anomaly in many cases without resort to cardiac catheterisation which has a relatively high risk in this disease.
对11例经心导管检查证实患有三尖瓣埃布斯坦畸形的患者进行了M型超声心动图研究，其中大多数为成年人。所有病例均同时记录三尖瓣和二尖瓣，7例患者的换能器位置在左锁骨中线外侧。所有病例中三尖瓣关闭均在二尖瓣关闭之后，间隔时间在0.04至0.14秒之间。由于在8500多次常规超声心动图研究中，仅1例无埃布斯坦畸形的患者出现了0.09至0.12秒的瓣膜关闭间隔，因此0.065秒或更长的间隔应被视为埃布斯坦病的诊断依据；然而，短于0.065秒的间隔并不能排除该诊断。所有患者均发现有矛盾性室间隔运动。2例患者显示三尖瓣前叶舒张期运动呈非典型的三峰模式，1例患者还显示二尖瓣脱垂。超声心动图显示的病理性三尖瓣关闭延迟使得在许多情况下无需进行心导管检查就能诊断埃布斯坦畸形，而心导管检查在这种疾病中具有相对较高的风险。
