缺血性心肌病与扩张型心肌病的超声心动图特征比较与鉴别诊断

 目的 探讨超声心动图对缺血性心肌病(ischemic cardiomyopathy,ICM)及扩张型心肌病(dilated cardiomyopathy,DCM) 的鉴别诊断价值。方法 收集175例因心功能不全、射血分数低且超声提示心脏扩张的患者,在纠正心衰后行选择性冠状动脉造影(selective coronary angiography,CAG),明确诊断为ICM或DCM,结果ICM组94例,DCM组81例,应用超声心动图分别对2组从心脏形态学、血流动力学及房室功能等方面进行比较。结果 ICM 组与 DCM 组多项超声指标间差异均有统计学意义(P<0.05或P<0.01)。相对于ICM ,DCM组患者心脏射血分数更低,DCM组的左房内径,右室内径,左室舒张末内径均大于ICM组,同时,DCM组的左室缩末容积及左室舒末容积均大于ICM组,同时,前者的主动脉瓣,肺动脉瓣口血流速度均小于后者。结论 ICM与DCM的心脏结构在超声的显示上有明显不同,前者心脏腔室内径相对较大,且主动脉瓣及肺动脉瓣口血流速度小于后者。

Differernt echocardiographic features of ischemic cardiomyopathy and dilated cardiomyopathy: A cohort study

Objective To investigate the value of echocardiography in the differential diagnosis of ischemic cardiomyopathy (ICM) and dilated cardiomyopathy (DCM).Methods One hundred and seventy-five cases were enrolled into this study who had been diagnosed with the symptoms of heart failure,low ejection fraction and enlargement of the heart indicated by cardiac ultrasound.After the remission of heart failure,they underwent selective coronary angiography (CAG)and were definitely diagnosed with ICM or DCM.The ICM group consisted of 94 patients and the DCM group 81 patients.Two dimensional color Doppler ultrasound echocardiography was used to find the difference in cardiac morphology,hemodynamics and ventricular function.Results There was significant differ ence in ultrasound echocardiography between the two groups (P ＜ 0.05 or P ＜ 0.01).Conclusions There is significant difference between ischemic cardiomyopathy and dilated cardiomyopathy in ultrasound echocardiography.In DCM,the chambers are relatively lar ger,and blood flow is faster.