ABSENCE OF PROGRESSION OF LEFT-VENTRICULAR HYPERTROPHY IN ADULT PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
ABSENCE OF PROGRESSION OF LEFT-VENTRICULAR HYPERTROPHY IN ADULT PATIENTS WITH HYPERTROPHIC CARDIOMYOPATHY
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DOI：
10.1016/s0735-1097(87)80301-7
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发表时间：
1987-05-01
影响因子：
24
通讯作者：
MARON, BJ
中科院分区：
文献类型：
--
作者：
SPIRITO, P;MARON, BJ
最近有报道称肥厚型心肌病患儿发生或发展为左心室肥厚。为了确定是否类似的变化，左心室肥厚的大小和分布也可能发生在成人患者与这种疾病，一系列的评估左心室壁厚度获得M型和二维超声心动图在65例肥厚型心肌病患者，年龄在23至50岁。随访3 ~ 6年，平均4年。65名患者中没有一个显示出显著增加（≥ 10%）。5 mm）;然而，9例（14%）显示出显著降低（5至9 mm）。室壁变薄最常见于前室间隔（7例），但也见于后室间隔（6例）、外侧游离壁（2例）和后游离壁（1例）。在9例室壁变薄的患者中，左心室舒张末期直径显著增加（从44 ± 1.5 mm增加到44 ± 1.5 mm）。6到51 .+-. 6 mm; p < 0.001）;然而，在9例中的7例中，绝对腔体尺寸保持在正常范围内（≤52 mm）。9例左室壁变薄和相对腔扩大的患者中有8例症状严重，1例症状轻微。总之，在任何研究患者中均未发现左心室肥大的实质性进展。因此，如果这种进展发生在患有肥厚型心肌病的成年人中，可能是罕见的。相反，一个重要的少数成人肥厚型心肌病患者可能表现为进行性左室壁变薄和相对腔扩大，这通常与严重的心脏症状。
Development or progression of left ventricular hypertrophy has recently been described in children with hypertrophic cardiomyopathy. To determine whether similar changes in magnitude and distribution of left ventricular hypertrophy may also occur in adult patients with this disease, serial assessment of left ventricular wall thickness was obtained with M-mode and two-dimensional echocardiography in 65 patients with hypertrophic cardiomyopathy who were 23 to 50 years of age. The follow-up period was 3 to 6 years (mean 4). None of the 65 patients showed a substantial increase (.gtoreq. 5 mm) in left ventricular wall thickness; however, 9 (14%) demonstrated a substantial decrease (5 to 9 mm). Wall thinning most commonly involved the anterior ventricular septum (seven patients), but was also identified in the posterior septum (six patients), lateral free wall (two patients) and posterior free wall (one patient). In the nine patients with wall thinning, left ventricular end-diastolic diameter increased significantly (from 44 .+-. 6 to 51 .+-. 6 mm; p < 0.001); however, in seven of the nine, absolute cavity size remained within normal limits (.ltoreq. 52 mm) at the most recent evaluation. Eight of the nine patients with left ventricular wall thinning and relative cavity enlargement were severely symptomatic and one was mildly symptomatic. In conclusion, substantial progression of left ventricular hypertrophy was not identified in any of the study patients. Hence, if such progression occurs in adults with hypertrophic cardiomyopathy, it is probably rare. Conversely, an important minority of adult patients with hypertrophic cardiomyopathy may show progressive left ventricular wall thinning and relative cavity enlargement, which ware usually associated with severe cardiac symptoms.