Temporal echocardiography findings in patients with fulminant myocarditis: beyond ejection fraction decline
Temporal echocardiography findings in patients with fulminant myocarditis: beyond ejection fraction decline
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暴发性心肌炎患者的颞部超声心动图检查结果：超越射血分数下降
DOI：
10.1007/s11684-019-0713-9
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发表时间：
2020-06-01
影响因子：
8.1
通讯作者：
Wang, Dao Wen
中科院分区：
文献类型：
--
作者：
Zuo, Houjuan;Li, Rui;Wang, Dao Wen
斑点追踪超声心动图（STE）对暴发性心肌炎（FM）患者心肌毒株的特征尚未明确。在这项研究中，监测左心室射血分数（LVEF）和整体和层特异性心肌应变随时间的变化。我们的目的是确定FM的超声心动图模式，并确定其在FM治疗中的意义。前瞻性纳入20例临床诊断为FM并接受机械生命支持的患者。常规超声心动图测量，并从入院至出院至LVEF恢复（> 50%）进行连续应变超声心动图检查。对14例FM患者的整体/区域收缩期纵向峰值应变（GLS/RLS）和层特异性纵向应变进行量化，并监测其随时间的变化。所有患者心功能均严重受损。6天内观察到LVEF和GLS的急剧改善。层特异性应变分析表明，心内膜和心外膜应变在入院时的减少或出院时的恢复是相等的。综上所述，接受机械循环支持的FM患者在6天内心室功能明显改善。心内膜和心外膜中肌张力均严重受损和RLS减少的斑片状和弥漫性分布是诊断FM的重要特征。
The features of myocardial strains from speckle-tracking echocardiography (STE) have not been well defined in fulminant myocarditis (FM) patients. In this study, changes in the left ventricular ejection fraction (LVEF) and global and layer-specific myocardial strains over time were monitored. We aimed to determine the echocardiographic patterns of FM and ascertain their significance in FM treatment. Twenty patients who were clinically diagnosed with FM and received mechanical life support were prospectively enrolled. Conventional echocardiographic measurements were obtained, and serial strain echocardiography was performed from admission to hospital discharge until LVEF recovery (> 50%). Global/regional peak systolic longitudinal strains (GLS/RLS) and layer-specific longitudinal strains were quantified, and their changes with time were monitored in 14 FM patients. All patients had severely impaired cardiac function. Steep improvement in LVEF and GLS were observed within 6 days. Layer-specific strain analysis showed that reduction at admission or recovery at discharge in the endocardium and epicardium strains were equal. In conclusion, FM patients who received mechanical circulatory supports exhibited steep improvement in ventricular function within 6 days. The patchy and diffused distribution pattern of reduced RLS and equally and severely impaired strain in the endocardium and epicardium are valuable features in the diagnosis of FM.