超声心动图评价以右心室病变为主的心肌病

目的探讨以右心室病变为主的心肌病的彩色多普勒超声显像特点。方法应用彩色多普勒超声心动图诊断以右心室病变为主的心肌病患者13例．结果11例患者右心房明显增大，所有患者均有不同程度的三尖瓣关闭不全，1例患者左心室轻度增大。超声心动图观察右心室形态变化．8例以右心室显著增大为主要特点，表现为右心室弥漫性扩大或局限性扩张．右室壁变薄，右室壁普遍性或局限性运动减弱，心尖小梁部和右室流人部肌小梁粗大，回声增强。5例以右室心尖小梁部闭塞为主要特点，表现为右室腔缩小、变形，心尖小梁部明显缩小或完全闭塞，右室流出道正常或扩张，增厚的右室壁回声增强，心包膜厚度正常。结论以右心室病变为主的心肌病超声显像特点为右室扩大、室壁变薄、运动减弱或右室腔缩小、变形．心尖小梁部明显缩小或完全闭塞等两种表现。这些特征对以右心室病变为主的心肌病具有较高的诊断价值。

Evaluation of the cardiomyopathies with predominant right ventricular involvement by echocardiography]

OBJECTIVE: To investigate the echocardiographic features of cardiomyopathies with predominant right ventricular involvement. METHODS: Echocardiography was used for diagnosis of cardiomyopathies with predominant right ventricular involvement in 13 cases. RESULTS: Obvious right atrial enlargement was observed in 11 patients, and all the 13 patients had tricuspid regurgitation of different degrees with normal or basically normal left ventricular size. One patient had mild left ventricular enlargement. Echocardiography demonstrated in these cases characteristic abnormalities of right ventricular cardiomyopathy, classified into two types based on the echocardiographic features of the right ventricular dilation or apical obliteration. Eight patients had pronounced right ventricular dilatation and hypokinesia with right ventricular wall thinning, evident echo enhancement and irregularity of the moderator band and right ventricular papillary muscles, as well as prominent trabeculations. In the other 5 patients, obliterative changes were found in the apical trabecular region of the right ventricle, presenting deflated and deformed right ventricle with shrinkage or obliteration of the apical trabecular region, increased right ventricular wall thickness producing echo enhancement, but the pericardial thickness remained normal with normal or dilated right ventricular inflow and outflow tracts. CONCLUSIONS: The echocardiographic features of cardiomyopathies with predominant right ventricular involvement can be classified into two types, one of which is characterized by obviously dilated right ventricle with wall thinning and hypokinesia, and the other by obliterative changes in the apical trabecular region of the right ventricle with deformed right ventricular cavity, stiffened and thickened right ventricular wall with echo enhancement and normal pericardium. The echocardiographic characteristics are useful for the diagnosis of this disease.