PATTERNS AND SIGNIFICANCE OF DISTRIBUTION OF LEFT-VENTRICULAR HYPERTROPHY IN HYPERTROPHIC CARDIOMYOPATHY - A WIDE ANGLE, 2 DIMENSIONAL ECHOCARDIOGRAPHIC STUDY OF 125 PATIENTS
PATTERNS AND SIGNIFICANCE OF DISTRIBUTION OF LEFT-VENTRICULAR HYPERTROPHY IN HYPERTROPHIC CARDIOMYOPATHY - A WIDE ANGLE, 2 DIMENSIONAL ECHOCARDIOGRAPHIC STUDY OF 125 PATIENTS
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DOI：
10.1016/0002-9149(81)90068-0
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发表时间：
1981-01-01
影响因子：
2.8
通讯作者：
EPSTEIN, SE
中科院分区：
文献类型：
--
作者：
MARON, BJ;GOTTDIENER, JS;EPSTEIN, SE
本文应用宽角二维超声心动图对125例肥厚型心肌病患者的左室肥厚分布进行了研究。最常见的（52%的患者）肥厚涉及室间隔和左室前外侧游离壁（III型）的大部分。在其他患者中，肥厚仅限于室间隔前部（I型），累及整个室间隔但不累及左心室游离壁（II型），或在左心室基底部前室间隔以外的区域发现（IV型）。后一种类型的患者，传统的M型超声心动图未能确定肥厚的存在，因此肥厚型心肌病的诊断只能建立与二维超声心动图。患者最广泛的肥厚，涉及大部分的室间隔，以及部分的游离壁（III型）不同于患者的其他模式的肥厚。(1)他们更常出现中度至重度功能受限（65例患者中有38例[58%]对60例患者中有16例[27%];概率[p] <0.001），（2）他们在基础状态下更常表现出左心室流出道阻塞（65例患者中有36例[55%]对60例患者中有11例[18%]; p <0.001）。因此，在肥厚型心肌病患者中，广角二维超声心动图能够检测到涉及多种模式的心肌肥厚，并且比M型超声心动图更广泛。虽然在大多数肥厚型心肌病患者中，左心室肥厚是“不对称的”，但它通常不限于室间隔，通常累及左心室前外侧游离壁，但很少累及左心室游离壁的后部（M型射束通过）。
Four patterns of distribution of left ventricular hypertrophy were identified by a wide angle, two dimensional echocardiographic study of 125 patients with hypertrophie Cardiomyopathy. Most commonly (52 percent of patients) hypertrophy involved substantial portions of both the ventricular septum and anterolateral left ventricular free wall (type III). In other patients, hypertrophy was confined to the anterior portion of the ventricular septum (type I), involved the entire ventricular septum but not the left ventricular free wall (type II) or was identified in regions of the left ventricle other than the basal anterior ventricular septum (type IV). In patients with the latter type, conventional M mode echocardiography failed to identify the presence of hypertrophy and therefore the diagnosis of hypertrophic Cardiomyopathy could be established only with two dimensional echocardiography.Patients with the most widespread hypertrophy involving most of the ventricular septum as well as portions of the free wall (type III) differed from patients having the other patterns of hypertrophy. (1) They more commonly experienced moderate to severe functional limitation (38 of 65 [58 percent]versus 16 of 60 [27 percent]; probability [p] <0.001), and (2) they more often demonstrated obstruction to left ventricular outflow under basal conditions (36 of 65 [55 percent]versus 11 of 60 [18 percent]; p <0.001). Hence, in patients with hypertrophic Cardiomyopathy, wide angle two dimensional echocardiography is capable of detecting myocardial hypertrophy that involves a variety of patterns and is more extensive than may be appreciated with M mode echocardiography. Although left ventricular hypertrophy is “asymmetric” in most patients with hypertrophic Cardiomyopathy, it is usually not confined to the ventricular septum and often involves the anterolateral left ventricular free wall, but it rarely involves the posterior portion of the left ventricular free wall (through which the M mode beam passes).