Quantitative diagnosis of apical cardiomyopathy using contrast echocardiography.
Quantitative diagnosis of apical cardiomyopathy using contrast echocardiography.
复制标题
使用对比超声心动图定量诊断心尖型心肌病。
DOI：
10.1067/mje.2002.119825
复制
发表时间：
2002
期刊：
影响因子：
--
通讯作者：
R. Lang
中科院分区：
文献类型：
--
作者：
R. Ward;L. Weinert;K. Spencer;Kathy T. Furlong;J. Bednarz;J. DeCara;R. Lang
背景
超声心动图对心尖肥厚型心肌病(ACM)的诊断受到心尖部心内膜经常无法显示的限制。我们假设，在疑似ACM的患者中使用造影剂，但进行非诊断性超声心动图检查，可以进行定量诊断。
方法
对26例非诊断性经胸超声心动图(TTES)诊断为ACM的患者，6例因单光子发射计算机断层扫描(SPECT)胸前T波倒置和心尖部示踪剂摄取增加而怀疑ACM的患者进行对比增强，10例心电图读数正常且无高血压病史的患者(健康组)，10例高血压患者和10例有高血压和心电图左室肥厚标准的患者(LVH组)。使用Optison(Mallinckrodt Medical；IV，1.0mL)使用谐波成像和低机械指数获得图像。在胸骨旁长轴切面上测量舒张末时的后壁(PW)和隔壁(Sw)厚度。在心尖四腔观下测量心尖壁厚度(A)，从增强后的心内膜到心外膜内脏表面。计算每组的A/PW和A/S比值。非对称性心尖肥厚定义为A/PW比值大于1.5。
结果
在可疑的ACM组中，所有患者的对比增强后心尖厚度均大于2.0 cm，而在LVH组和健康组中，所有患者的心尖厚度均小于1.2 cm。在疑似ACM组的6例患者中，A/PW和A/SW比值均大于1.5。健康组和左心室肥厚组中没有患者的厚度比大于0.85。
结论
超声心动图可以定量诊断心电图和SPECT提示但不能诊断TTE的ACM。这项研究建议，在对这种情况进行更昂贵或更具侵入性的诊断测试之前，应该进行声学造影。
BACKGROUND
The echocardiographic diagnosis of apical hypertrophic cardiomyopathy (ACM) has been limited by the frequent inability to visualize the apical endocardium. We hypothesized that the use of contrast agents in patients with suspected ACM, but nondiagnostic echocardiographic studies, would allow quantitative diagnosis.
METHODS
Contrast enhancement was performed in 26 patients with nondiagnostic transthoracic echocardiograms (TTEs) for the diagnosis of ACM; 6 patients with suspected ACM based on unexplained symmetric precordial T-wave inversions and increased apical tracer uptake on single-photon emission computed tomography (SPECT) scans, 10 patients with normal electrocardiogram (ECG) readings and no history of hypertension (healthy group), and 10 patients with hypertension and ECG criteria for left ventricular hypertrophy (LVH group). Images were obtained with Optison (Mallinckrodt Medical; IV, 1.0 mL) using harmonic imaging and low mechanical index. Posterior (PW) and septal wall (SW) thicknesses were measured at end-diastole in the parasternal long-axis view. Apical wall thickness (A) was measured from the contrast-enhanced apical endocardium to the visceral epicardial surface in the apical 4-chamber view. A/PW and A/SW ratios were calculated for each group. Asymmetric apical hypertrophy was defined as an A/PW ratio greater than 1.5.
RESULTS
Contrast-enhanced apical thickness was greater than 2.0 cm in all patients in the suspected ACM group but less than 1.2 cm in all patients in the LVH and healthy groups. In all 6 patients in the suspected ACM group, A/PW and A/SW ratios were greater than 1.5. No patient in the healthy or LVH groups had thickness ratios greater than 0.85.
CONCLUSION
Contrast echocardiography allows quantitative diagnosis of ACM in patients with suggestive ECG and SPECT but nondiagnostic TTEs. This study suggests that contrast echocardiography should be performed before using more expensive or invasive diagnostic testing for this condition.
影响因子：
5.9
作者：
PRYOR, DB;HARRELL, FE;ROSATI, RA
通讯作者：
ROSATI, RA