心内膜弹力纤维增生症的心功能改变:多普勒组织显像与传统功能指标对比

Evaluation of Cardiac function in children with endocardial fibroelastosis: Comparison of Doppler tissue imaging and conventional ultrasound cardiography

为探讨心内膜弹力纤维增生症(EFE)的心功能改变及病变部位,采用多普勒组织显像(DTI)及传统超声心动图(UCG)检查了10例EFE和143例正常儿童,结果DTI指标中二尖瓣环收缩期及舒张早期运动速度(MVR-SV及MVR-DeV)、左室后壁心内膜收缩期及舒张期运动速度(LVPW-EnSV、LVPW-EnDV)全部病例显著降低。其异常率高于传统心功能指标。二尖瓣血流E峰与A峰之比在EFE显著降低。结论:DTI为EFE的诊断、病变部位的确定、心功能的了解提供了一个敏感而实用的新方法;E/A对鉴别EFE与扩张型心肌病(DCM)有重要参考价值。

To explore the change of cardiac function and affected location in children with endocardial fibroelastosis (EFE), 10 EFE cases and 143 normal children were evaluated by Doppler tissue imaging (DTI) and conventional ultrasound cardiography(UCG). The results showed that the DTI parameters such as mitral valvular ring systolic velocity(MVR -SV) (3. 0±0. 9 vs. 7. 41 ±0. 68), diastolic early velocity (MVR -DeV)(4. 33±1. 03 vs. 12. 97±0. 9), and the endocardial systolic and diastolic velocities of left ventricular posterior walKLVPW -EnSV and LVPW -EnDV)(4. 5±1. 21 vs. 7. 15±0. 68; 5. 0 ±1. 32 vs. 15. 37±1. 17)were all lower significantly in the EFE patients than those in the normal children. It is obvious that there was a higher rate of the abnormal detection by DTI. E/A ratio of blood flow in mitral valvular decreased also in the EFE patients comparing to those in the normal subjects (1. 11±0. 12 vs. 1. 92±0. 18). It is suggested that DTI is a sensitive and utility method for the diagnosis of EFE, detection of affected location and realization of heart function in the EFE patients, and E/A ratio is also useful for differential diagnosis of EFE from dilated cardiomyopathy(DCM).