Wessel A, Schüller W C, Yelbuz T M, Bürsch J H
Department of Paediatric Cardiology, Georg-August-University, Göttingen, Germany.
Br Heart J. 1994 Aug;72(2):182-5. doi: 10.1136/hrt.72.2.182.
To investigate whether augmented chamber performance in children with a concentric hypertrophied left ventricle is due to increased myocardial shortening or a geometric effect of the thickened ventricular wall.
Chamber performance in terms of fractional area change and myocardial shortening--that is, circumferential midwall shortening--were measured by cross sectional echocardiography in young people with normal left ventricles and those with concentric hypertrophy of the left ventricle.
52 healthy infants, children, and young people (age range 3 1/2 weeks to 26 years; body weight 1.8-89 kg (mean 23.6 kg)) and 29 infants, children, and adolescents with ventricular hypertrophy (mean body weight 31.4 kg, age range 4 weeks to 18.7 years).
Chamber areas, fractional area change, midwall circumferential shortening normalised to body weight.
In the controls normalised reference values were: end diastolic cavity area, 1.47 (0.25) cm2/kg0.65; fractional area change, 0.56 (0.03); end diastolic myocardial area, 1.62 (0.25) cm2/kg0.55; midwall circumferential shortening, 0.21 (0.03). By comparison, the patients had normal chamber areas (end diastolic myocardial area, 1.57 (0.42) cm2/kg0.65), increased fractional area change, 0.68 (0.05) (P < 0.001), and normal midwall circumferential shortening, 0.21 (0.03). There was a significant relation between the degree of hypertrophy (in terms of end diastolic myocardial area) and pump function while midwall shortening remained constant: 0.08 x end diastolic myocardial area + 0.44 (r = 0.74, P < 0.001).
The relation between myocardial shortening, wall thickness, and fractional area change emphasises that the augmentation of pump function variables in left ventricular hypertrophy in young people is an effect of the thickened wall and not necessarily due to increased myocardial shortening. This relation offers the possibility of assessing the adequacy of chamber performance with respect to the degree of hypertrophy.
探讨同心性肥厚左心室患儿的心室功能增强是由于心肌缩短增加还是增厚心室壁的几何效应所致。
通过横断面超声心动图测量左心室正常的年轻人和左心室同心性肥厚的年轻人的心室功能，以面积变化分数和心肌缩短（即圆周中层壁缩短）来表示心室功能。
52名健康婴儿、儿童和年轻人（年龄范围3.5周至26岁；体重1.8 - 89千克（平均23.6千克））以及29名患有心室肥厚的婴儿、儿童和青少年（平均体重31.4千克，年龄范围4周至18.7岁）。
心室面积、面积变化分数、按体重标准化的中层壁圆周缩短。
对照组的标准化参考值为：舒张末期腔面积，1.47（0.25）平方厘米/千克^0.65；面积变化分数，0.56（0.03）；舒张末期心肌面积，1.62（0.25）平方厘米/千克^0.55；中层壁圆周缩短，0.21（0.03）。相比之下，患者的心室面积正常（舒张末期心肌面积，1.57（0.42）平方厘米/千克^0.65），面积变化分数增加，为0.68（0.05）（P < 0.001），中层壁圆周缩短正常，为0.21（0.03）。肥厚程度（以舒张末期心肌面积表示）与泵功能之间存在显著关系，而中层壁缩短保持不变：0.08×舒张末期心肌面积 + 0.44（r = 0.74，P < 0.001）。
心肌缩短、壁厚和面积变化分数之间的关系强调，年轻人左心室肥厚中心室功能变量的增强是增厚壁的效应，不一定是由于心肌缩短增加。这种关系提供了根据肥厚程度评估心室功能是否充足的可能性。
