Mirode A, Tribouilloy C, Boey S, Hadj Kacem L, Choquet D, Lesbre J P
Service de Cardiologie B, Hôpital Sud, Amiens.
Ann Cardiol Angeiol (Paris). 1993 Jan;42(1):7-12.
The aim of this study was to evaluate the contribution of transesophageal echocardiography to the diagnosis of aneurysms of the interatrial septum and to identify the role played by this condition in unexplained systemic embolic accidents. Thirty two aneurysms of the interatrial septum were discovered in a consecutive series of 751 transesophageal echocardiograms, i.e. an incidence of 4.2 per cent. The diagnosis was possible by transthoracic echocardiography in only 9 cases (28%). Search for a patent foramen ovale by a contrast test was positive in 87 per cent of cases of aneurysm of the interatrial septum as compared with 45 per cent for patients without an aneurysm (p < 0.01). In patients in whom transesophageal echocardiography was requested for etiological evaluation of an ischemic vascular accident of embolic origin (n = 191), an aneurysm of the interatrial septum was found in 8.3 per cent of cases. In patients with no history of a systemic embolic accident (n = 560), the incidence of septums of the interatrial septum was 2.8 per cent (p < 0.01). Furthermore, 50 per cent of patients with an aneurysm of the interatrial septum had a history of systemic embolism. Transesophageal echocardiography thus appears to be superior to transthoracic echocardiography in the positive diagnosis of aneurysms of the interatrial septum and our study is suggestive of their emboligenic nature.
本研究的目的是评估经食管超声心动图对房间隔瘤诊断的贡献，并确定这种情况在不明原因的系统性栓塞事件中所起的作用。在连续的751例经食管超声心动图检查中发现了32例房间隔瘤，即发病率为4.2%。仅9例（28%）通过经胸超声心动图得以诊断。对比试验发现房间隔瘤患者中卵圆孔未闭的检出率为87%，而无房间隔瘤患者为45%（p<0.01）。在因栓塞性起源的缺血性血管事件而接受经食管超声心动图病因评估的患者（n=191）中，8.3%发现有房间隔瘤。在无系统性栓塞事件病史的患者（n=560）中，房间隔瘤的发生率为2.8%（p<0.01）。此外，50%的房间隔瘤患者有系统性栓塞病史。因此，经食管超声心动图在房间隔瘤的阳性诊断方面似乎优于经胸超声心动图，并且我们的研究提示了它们的致栓性质。
