超声心动图评价致心律失常性右心室心肌病病变程度的临床研究

目的 分析致心律失常性右心室心肌病(ARVC)患者的病变程度与超声心动图表现之间的关系.方法 分析61例已确诊的ARVC患者,根据心脏磁共振(MRI)检查结果,将其按病变侵犯部位分为右心室局部病变组(A组)、右心室弥漫病变组(B组)、累及左心室的双心室病变组(C组),分析比较3组间的超声心动图.结果 心脏MRI结果示,A组患者19例(31%),B组28例(46%),C组14例(23%).共15例(25%)患者超声心动图结果正常(A组13例,B组2例).A组患者中均无右心房增大、右心室室壁变薄、右心室室壁运动减弱.超声心动图示:右心房、心室增大,右心室流出道增宽、右心室室壁变薄及室壁运动减弱均与病变程度呈正相关,而左心参数差异均无统计学意义.结论 早期无症状或局部轻度病变时应用超声心动图检查容易漏诊,应当结合临床表现、心电图并进行心脏MRI检查.依据超声心动图结果中右心参数可以判断病变进展程度,指导治疗方案的选择.

Echocardiographic evaluation of the disease extent in patients with arrhythmogenic right ventricular cardiomyopathy

Objective To analyze the relationship between the disease extent and the echocardiographic characteristics in patients with arrhythmogenic right ventricular cardiomyopathy (ARVC). Methods The study group consisted of 61 subjects with a definite diagnosis of ARVC on the basis of published criteria. We classified patients into 3 groups( local right ventricular group-group A ,severe right ventricular group-group B and biventricular group-group C)according to cardiac magnetic resonance imaging(MRI). Statistical analysis was used to evaluate the echocardiographic parameters among the three groups. Results Group A had 19 patients (31% ).Group B had 28 patients(46% ). Group C had 14 patients(23% ). Fifteen(25% )patients had normal echocardiography(group A had 13 patients,group B had 2 patients). There was not right atrial dilatation,right ventricular wall thinning,right ventricular wall motion abnormalities in the group A patients. Right atrial dilatation,right ventricle dilatation,right ventricular outflow tract dilatation,right ventricular wall thinning,right ventricular wall motion abnormalities were correlated with the disease, while the left heart parameters were no statistical difference. Conclusions In early stage of disease echocardiography may cause misdiagnosis. The combination of clinical manifestations,with electrocardiogram,and cardiac MRI is necessary. Echocardiographic parameters are useful to judge the extent of disease progress,and can guide treatment programs.