SERIAL DOPPLER ECHOCARDIOGRAPHIC FOLLOW-UP OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN CARDIAC AMYLOIDOSIS
SERIAL DOPPLER ECHOCARDIOGRAPHIC FOLLOW-UP OF LEFT-VENTRICULAR DIASTOLIC FUNCTION IN CARDIAC AMYLOIDOSIS
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DOI：
10.1016/0735-1097(90)90545-z
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发表时间：
1990-11-01
影响因子：
24
通讯作者：
TAJIK, AJ
中科院分区：
文献类型：
--
作者：
KLEIN, AL;HATLE, LK;TAJIK, AJ
心脏淀粉样变性患者在多普勒超声心动图上发现左室舒张期充盈异常频谱。为了确定这些充盈异常如何随时间演变以及任何变化的意义，在12.6 ±. 4.9 41名连续患者（36名男性和15名女性，平均年龄为59 ± 10岁）在20个月内进行了研究。11岁），具有心脏受累的典型二维超声心动图特征。测量左室舒张早期最大流入量（E）和心房收缩（A）速度、E/A比值、减速时间和等容舒张时间。根据平均左心室壁厚度将患者分为24名患者的早期组（< 15 mm）和晚期组（≥ 15 mm）。15 mm）。总的组显示出增加的E/A比率（1.7 ± 0.01）。0.9对1.4 .+-。0.9，p = 0.009）和减少的时间（164 . ±. 57对174。51 ms，p = 0.11）。早期组显示E/A比率的显著变化（1.6 ± 1.5）。1.0对1.2 .+-。0.7，p = 0.001）。早期组中有7名患者（29%）表现出从异常松弛或“正常”模式到限制模式的变化，其中6名患者的症状增加。晚期组17例患者中有15例（88%）在随访研究期间未显示出显著的测量变化，但这些患者已经显示出限制性模式。因此，在短期随访评估中，一系列左心室血流速度变量发生显著变化，主要发生在心脏淀粉样变性的早期组。
A spectrum of left ventricular diastolic filling abnormalities noted on Doppler echocardiography has been demonstrated in patients with cardiac amyloidosis. To determine how these filling abnormalities evolve over time and the significance of any change, serial pulsed wave Doppler studies of left ventricular inflow were performed over 12.6 .+-. 4.9 months in 41 consecutive patients (36 men and 15 women, mean age 59 .+-. 11 years) with typical two-dimensional echocardiographic features of cardiac involvement. The measurements were peak left ventricular inflow in early diastole (E) and atrial contraction (A) velocities, E/A ratio, deceleration time and isovolumetric relaxation time. Patients were classified by mean left ventricular wall thickness into an early group (< 15 mm) of 24 patients and an advanced group (.gtoreq. 15 mm) of 17 patients. The total group showed an increased E/A ratio (1.7 .+-. 0.9 versus 1.4 .+-. 0.9, p = 0.009) and decreased time (164 .+-. 57 versus 174 .+-. 51 ms, p = 0.11) at follow-up compared with baseline study. The early group showed significant changes in the E/A ratio (1.6 .+-. 1.0 versus 1.2 .+-. 0.7, p = 0.001) between the two studies. Seven patients (29%) in the early group showed a change from an abnormal relaxation or "normal" pattern to one of restriction, coincident with increased symptoms in six of these patients. Fifteen (88%) of the 17 patients in the advanced group did not show significant changes in the measures during the follow-up study, but these patients already showed a restrictive pattern. Thus, significant changes in serial left ventricular flow velocity variables occur during short-term follow-up evaluation, predominantly in the early group with cardiac amyloidosis.