左心室造影诊断特殊类型肥厚型心肌病的临床意义(附21例报告)

The clinical significance of left ventricular angiography in the diagnosis of special subtypical hypertrophic cardiomopathy (a report with 21 cases)

目的 评价左心室造影对诊断特殊类型肥厚型心肌病的临床价值。方法 以心电图、超声心动图、冠状动脉造影及左心室造影等检查方法诊断21例特殊类型肥厚型心肌病。结果 21例心电图均显示相应导联的T波倒置,但只有8例患者达到对称深倒的标准;超声心动图只检出其中的9例患者符合局部肥厚型心肌病;左心室造影检出全部病例的局部心肌肥厚,18例诊断为心尖肥厚型心肌病,3例诊断为心室中部肥厚型心肌病,其中心尖肥厚型有11例呈左心室“黑桃”样改变。冠状动脉造影全部病例大致正常。结论 左心室造影在诊断特殊类型肥厚型心肌病中有重要价值,可明显提高该疾病的检出率。

Objective To evaluate the value of left ventricular angiography in the diagnosis of special subtypical hypertrophic cardiomyopathy (HCM). Methods 21 cases of subtypical HCM were studied by electrocardiography(ECG), two-dimensional echocardography, left ventricular angiogram (LVG) and coronary angiography. Results ECG showed T wave inversion in related leads in 21 cases, but the amplitudes of inverted T wave≥1.0mV only in 8 cases; Echocardiography discoved hypertrophic local left ventricular wall in 8 cases. LVG demonstrated subtypical HCM with normal coronary angiography in all 21 cases (18 cases of apical HCM had the apical ' spade' changes. Conclusion LVG is very helpful in the diagnosis of subtypical HCM with high sensitive and specificity.