中华心血管病杂志
中華心血管病雜誌
중화심혈관병잡지
Chinese Journal of Cardiology
2012年
12期
1012-1015
,共4页
闫朝武%李建荣%赵世华%凌坚%孙欣%孟红%王浩
閆朝武%李建榮%趙世華%凌堅%孫訢%孟紅%王浩
염조무%리건영%조세화%릉견%손흔%맹홍%왕호
心肌疾病%疾病特征%超声心动描记术
心肌疾病%疾病特徵%超聲心動描記術
심기질병%질병특정%초성심동묘기술
Cardiomyopathies%Disease attributes%Echocardiography
目的 探讨左心室(左室)心尖发育不良的临床和影像学特征.方法 入选2008年1月至2012年1月诊断为左室心尖发育不良的患者7例(男性3例,女性4例),年龄6 ~44(19.9±14.2)岁.患者均接受经胸超声心动图检查;其中3例患者接受心血管MRI检查;2例患者接受CT检查,其中1例患者同时接受心导管和造影检查.分析患者的临床和影像学特征.结果 7例患者中,以胸闷不适就诊4例,3例患者心前区可闻及杂音.心电图显示3例患者合并心房颤动.影像学检查显示,患者的左室心尖部均扁平,心腔呈球形改变;左室横径均增大而纵径相对短缩,横径为(57.9±11.6) mm;室间隔均凸向右室,厚度为(7.3±1.2) mm;左室射血分数为(47.6±17.2)%,其中2例患者的左室射血分数减低;左室乳头肌均附着于扁平的左室前壁心尖部;右室腔均增大并包绕发育不良的左室心尖部,右室横径为(19.7±7.6) mm;接受心血管MRI或CT检查的5例患者均在心尖部存在脂肪替代.结论 左室心尖发育不良的临床表现各异,影像学以左室心尖部扁平、心腔球形改变、左室乳头肌异常附着于前壁心尖部以及右室远端包绕发育不良的左室心尖为特征.
目的 探討左心室(左室)心尖髮育不良的臨床和影像學特徵.方法 入選2008年1月至2012年1月診斷為左室心尖髮育不良的患者7例(男性3例,女性4例),年齡6 ~44(19.9±14.2)歲.患者均接受經胸超聲心動圖檢查;其中3例患者接受心血管MRI檢查;2例患者接受CT檢查,其中1例患者同時接受心導管和造影檢查.分析患者的臨床和影像學特徵.結果 7例患者中,以胸悶不適就診4例,3例患者心前區可聞及雜音.心電圖顯示3例患者閤併心房顫動.影像學檢查顯示,患者的左室心尖部均扁平,心腔呈毬形改變;左室橫徑均增大而縱徑相對短縮,橫徑為(57.9±11.6) mm;室間隔均凸嚮右室,厚度為(7.3±1.2) mm;左室射血分數為(47.6±17.2)%,其中2例患者的左室射血分數減低;左室乳頭肌均附著于扁平的左室前壁心尖部;右室腔均增大併包繞髮育不良的左室心尖部,右室橫徑為(19.7±7.6) mm;接受心血管MRI或CT檢查的5例患者均在心尖部存在脂肪替代.結論 左室心尖髮育不良的臨床錶現各異,影像學以左室心尖部扁平、心腔毬形改變、左室乳頭肌異常附著于前壁心尖部以及右室遠耑包繞髮育不良的左室心尖為特徵.
목적 탐토좌심실(좌실)심첨발육불량적림상화영상학특정.방법 입선2008년1월지2012년1월진단위좌실심첨발육불량적환자7례(남성3례,녀성4례),년령6 ~44(19.9±14.2)세.환자균접수경흉초성심동도검사;기중3례환자접수심혈관MRI검사;2례환자접수CT검사,기중1례환자동시접수심도관화조영검사.분석환자적림상화영상학특정.결과 7례환자중,이흉민불괄취진4례,3례환자심전구가문급잡음.심전도현시3례환자합병심방전동.영상학검사현시,환자적좌실심첨부균편평,심강정구형개변;좌실횡경균증대이종경상대단축,횡경위(57.9±11.6) mm;실간격균철향우실,후도위(7.3±1.2) mm;좌실사혈분수위(47.6±17.2)%,기중2례환자적좌실사혈분수감저;좌실유두기균부착우편평적좌실전벽심첨부;우실강균증대병포요발육불량적좌실심첨부,우실횡경위(19.7±7.6) mm;접수심혈관MRI혹CT검사적5례환자균재심첨부존재지방체대.결론 좌실심첨발육불량적림상표현각이,영상학이좌실심첨부편평、심강구형개변、좌실유두기이상부착우전벽심첨부이급우실원단포요발육불량적좌실심첨위특정.
Objective To analyze the clinical and cardiac imaging characteristics of patients with left ventricular apical hypoplasia (LVAH).Methods From January 2008 to January 2012,seven patients [3 male/4 female,age:6-44 (19.9 ± 14.2)years] with LVAH were included in this cohort.Transthoracic echocardiogram was performed in all patients,cardiovascular MRI was performed in 3 patients and cardiovascular CT in another 2 patients.In addition,one LVAH patient underwent cardiac catheterization and angiography examination.Results Four out of 7 patients complained chest discomfort.Precordial murmur was heard in 3 patients.Atrial fibrillation was evidenced by electrocardiogram in 3 patients.Left ventricular end-diastolic diameter [(57.9 ± 11.6) mm] increased while left ventricule (LV) longitudinal diameter reduced in all patients.Left ventricular systolic function was reduced in 2 patients and mean LVEF was (47.6 ± 17.2)%.The interventricular septum bulged towards the right,and the ventricular septum thickness was (7.3 ± 1.2) mm.The papillary muscles were dominant on the flattened LV anteroapical region.The right ventricle elongated and wrapped around the hypoplastic left ventricular apex,and the dimension of right ventricle was (19.7 ± 7.6) mm.Focal fat replacement of the left ventricular apical wall was evidenced in 5 patients underwent cardiovascular MRI or CT examinations.Conclusions Clinical symptoms are non-specific in LVAH patients.Truncated and spherical LV,abnormal origin of papillary muscles in the flattened LV anterior apex and an elongated right ventricle wrapping around the LV apex as well as focal fat replacement of the left ventricular apical wall are typical imaging characteristics of LVAH.