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[用于心血管异常大规模筛查的超声心动图检查]

[Echocardiographic examinations for mass-screening of cardiovascular abnormalities].

作者信息

Sato H, Ozaki H, Hori M

机构信息

1st Department of Medicine, Osaka University School of Medicine, Suita.

出版信息

Rinsho Byori. 1995 Nov;43(11):1108-12.

PMID:8551673
Abstract

We evaluated the echocardiographic techniques for detecting left ventricular hypertrophy, mitral valve prolapse, and underlying abnormalities of nonspecific T wave changes on electrocardiograms during mass-screening medical examinations. The sensitivity and specificity of the electrocardiographic voltage criteria of Sokolow et al. for detecting left ventricular hypertrophy determined from the actual left ventricular wall thickness measured by echocardiograms in 759 young men, were only 61% and 54%, respectively. The diagnosis of left ventricular hypertrophy should be based on echocardiographic measurements even during mass-screening medical examinations. Mitral valve prolapse was detected in 25 (1.2%) of 2016 young healthy subjects. The mitral valve prolapse may not be a rare abnormality even in apparently normal subjects. Of 5217 consecutive subjects who underwent mass-screening medical examinations, 56 subjects had a mild T wave abnormality which was not explained by any of ischemic heart disease, hypertension, valvular heart disease, cardiomyopathy, and other systemic abnormalities. Careful echocardiographic examinations revealed regional or mild left ventricular hypertrophic lesions in 31 (55%) of these 56 subjects. We conclude that echocardiographic techniques are useful for detecting left ventricular hypertrophy and mitral valve prolapse and for elucidating the underlying abnormalities of nonspecific T wave changes during mass-screening medical examinations.

摘要

我们评估了超声心动图技术在大规模筛查体检中检测左心室肥厚、二尖瓣脱垂以及心电图非特异性T波改变的潜在异常情况的能力。根据759名年轻男性经超声心动图测量的实际左心室壁厚度来确定,Sokolow等人的心电图电压标准检测左心室肥厚的敏感性和特异性分别仅为61%和54%。即使在大规模筛查体检期间,左心室肥厚的诊断也应基于超声心动图测量。在2016名年轻健康受试者中,检测到25例(1.2%)二尖瓣脱垂。即使在看似正常的受试者中,二尖瓣脱垂也可能不是罕见的异常情况。在连续接受大规模筛查体检的5217名受试者中,有56名受试者出现轻度T波异常,且无法用任何缺血性心脏病、高血压、瓣膜性心脏病、心肌病及其他全身性异常来解释。仔细的超声心动图检查发现,这56名受试者中有31例(55%)存在局部或轻度左心室肥厚病变。我们得出结论,超声心动图技术在大规模筛查体检中对于检测左心室肥厚和二尖瓣脱垂以及阐明非特异性T波改变的潜在异常情况是有用的。

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