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儿童和成人肥厚型心肌病患者的心肌超声组织特征分析

Myocardial ultrasonic tissue characterization in pediatric and adult patients with hypertrophic cardiomyopathy.

作者信息

Vitale D F, Bonow R O, Calabrò R, De Cristofaro M, Pacileo G, Caso P, Gerundo G, Bordini C, Losi M A, Rengo C, Rengo F

机构信息

Facoltà di Medicina Federico II, Cattedra di Geriatria, Naples, Italy.

出版信息

Circulation. 1996 Dec 1;94(11):2826-30. doi: 10.1161/01.cir.94.11.2826.

Abstract

BACKGROUND

Hypertrophic cardiomyopathy (HCM) has different clinical and prognostic aspects in young than in adult patients. This study was undertaken to determine whether these reported differences are reflected by changes in ultrasonic backscatter parameters and whether oral treatment with verapamil modifies backscatter variables in children with HCM.

METHODS AND RESULTS

Sixty-eight subjects underwent backscatter analysis to assess the ultrasonic myocardial reflectivity and the amplitude of the cardiac cycle-dependent variation of the backscatter power curve. Subjects were divided into four groups: 10 HCM and 23 normal subjects < 10 years old and 17 HCM and 18 normal adults. Myocardial reflectivity and amplitude of the cyclic variation were assessed in the septum and in the posterior wall of all subjects. The children with HCM were restudied after long-term oral administration of verapamil. Both children and adult patients, compared with the normal control groups, showed a significant reduction in the amplitude of the cyclic variation both in the septum and in the posterior wall. In contrast, myocardial reflectivity, although significantly increased in adult HCM patients, was unchanged in the young HCM group. Verapamil administration did not significantly alter the results in the children with HCM.

CONCLUSIONS

These data demonstrate that in young HCM patients, the ultrasonic myocardial reflectivity is normal, in contrast to the significant increase observed in adult patients affected by the same disease. This observation is in accord with the different clinical manifestations reported in young HCM patients and indicates an age-dependent difference in the echogenic structure of the hypertrophied myocardium in HCM.

摘要

背景

肥厚型心肌病(HCM)在年轻患者和成年患者中具有不同的临床和预后特征。本研究旨在确定这些已报道的差异是否通过超声背向散射参数的变化得以体现,以及维拉帕米口服治疗是否会改变HCM患儿的背向散射变量。

方法与结果

68名受试者接受了背向散射分析,以评估超声心肌反射率和背向散射功率曲线的心动周期依赖性变化幅度。受试者被分为四组:10名10岁以下的HCM患儿和23名正常儿童,以及17名成年HCM患者和18名正常成年人。对所有受试者的室间隔和后壁的心肌反射率和周期性变化幅度进行了评估。对患有HCM的儿童长期口服维拉帕米后再次进行研究。与正常对照组相比,儿童和成年患者的室间隔和后壁的周期性变化幅度均显著降低。相比之下,心肌反射率虽然在成年HCM患者中显著增加,但在年轻HCM组中未发生变化。维拉帕米给药并未显著改变HCM患儿的结果。

结论

这些数据表明,年轻HCM患者的超声心肌反射率正常,这与患有相同疾病的成年患者中观察到的显著增加形成对比。这一观察结果与年轻HCM患者中报道的不同临床表现一致,并表明HCM中肥厚心肌的回声结构存在年龄依赖性差异。

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