應用超音波圖評估擴張性心肌病變嬰幼兒之左心室功能

Echocardiographic Assessment of Left Ventricular Function in Infants and Young Children with Dilated Cardiomyopathy

吳俊仁(Jiunn-Ren Wu) ； 黃德揚(Teh-Yang Huang)

《Acta Paediatrica Sinica》 28卷3期 (1987/06) Pp. 177-183

摘要

During a 4-year period, 18 consecutive patients, younger than 3 years of age, with dilated cardiomyopathy were studied. The diagnosis was based on clinincal manifestations, cardiomegaly on chest X-ray film and flat or inverted T waves on electrocardiograms. The parasternal long axis view of the two-dimensional echocardiography (echo) disclosed globular shaped left ventricle and fish-mouth appearance of the mitral valve which shifted to one side of the left ventricle during the cardiac cycle. A dense and thick echo shadow could also be found on the endocardial area of left ventricle in 7 patients. From the M-mode echo, 6 of the 18 patients had paradoxical septal motion. Several measurements were calculated from M-mode echo to assess the left ventricular functions. The results were summarized as follows: (1) significant increase of end-diastolic dimension of left ventricle, left atrial dimension and E point septal separation, (2) significant decrease of interventricular septal thickness, left ventricular posterior wall thickness, mitral DE excursion, the amplitude of left ventricular posterior wall echo during systole and the maximal rate of rise of the left ventricular posterior wall echo, (3) significant decrease of the percentage of shortening fraction, ejection fraction and the mean velocity of circumferential fiber shortening to 15.0±3.9%, 38.3±3.9% and 0.77±0.24 cir/sec, respectively. From this study, it could be concluded that the left ventricle was significantly enlarged with diminishing contraction and the mitral valve was displaced posteriorly in the left ventricular cavity, producing a large mitral E point septal separation. The echo could be used as an excellent noninvasive assessment of left ventricular function.

並列摘要

During a 4-year period, 18 consecutive patients, younger than 3 years of age, with dilated cardiomyopathy were studied. The diagnosis was based on clinincal manifestations, cardiomegaly on chest X-ray film and flat or inverted T waves on electrocardiograms. The parasternal long axis view of the two-dimensional echocardiography (echo) disclosed globular shaped left ventricle and fish-mouth appearance of the mitral valve which shifted to one side of the left ventricle during the cardiac cycle. A dense and thick echo shadow could also be found on the endocardial area of left ventricle in 7 patients. From the M-mode echo, 6 of the 18 patients had paradoxical septal motion. Several measurements were calculated from M-mode echo to assess the left ventricular functions. The results were summarized as follows: (1) significant increase of end-diastolic dimension of left ventricle, left atrial dimension and E point septal separation, (2) significant decrease of interventricular septal thickness, left ventricular posterior wall thickness, mitral DE excursion, the amplitude of left ventricular posterior wall echo during systole and the maximal rate of rise of the left ventricular posterior wall echo, (3) significant decrease of the percentage of shortening fraction, ejection fraction and the mean velocity of circumferential fiber shortening to 15.0±3.9%, 38.3±3.9% and 0.77±0.24 cir/sec, respectively. From this study, it could be concluded that the left ventricle was significantly enlarged with diminishing contraction and the mitral valve was displaced posteriorly in the left ventricular cavity, producing a large mitral E point septal separation. The echo could be used as an excellent noninvasive assessment of left ventricular function.

並列關鍵字

dilated cardiomyopathy ； echocardiography ； left ventricular function