55例左心室心肌致密化不全临床和超声心动图特点分析

Analysis of Clinical and Echocardiographic Characteristics in 55 Patients With Left Ventricular Noncompaction Myocardium

目的:探讨左心室心肌致密化不全(LVNC)临床和超声心动图特点。方法:采用Jenni提出的心肌致密化不全诊断标准,在陕西省3个心脏超声协作中心共检测出55例LVNC,收集其临床表现及超声特点进行分析。结果:55例LVNC,根据其临床表现和超声心动图特点分为典型组和可疑组。典型组LVNC 45例,其左心室内径扩大(67±11)mm,射血分数减低0.35±0.09,非致密层与致密层比值(N/C)>2。可疑组10例,其左心室内径正常(51±11)mm,射血分数正常0.65±0.08,N/C<2。在典型组45例中,合并心律失常11例,冠心病4例,二尖瓣返流43例,三尖瓣返流26例,心包积液16例,腔隙性脑梗塞1例。结论:LVNC在临床上尚没有得到广泛的认识,超声心动图在LVNC的诊断中具有特征性价值,但一些技术性问题有待深入探讨。

Objective： To explore the clinical and echocardiographic characteristics in patients with left ventricular noncompaction myocardium （LVNC）. Methods： According to Jenni＇s diagnosing criteria, a total of 55 LVNC patients from 3 centers of echocardiography in Shaanxi province were collected, the patients were divided into 2 groups, Typical group, n=45 and Suspicious group, n=10. The clinical manifestation and echocardiographic presentation were studied and compared between 2 groups. Results： In Typical group, the left ventricular chamber enlarged to （67±11）mm, ejection fraction decreased to 0.35±0.09, the ratio of noncompaction to compaction （N/C） 〉 2. In Suspicious group, the patients showed normal left ventricular chamber for （51±11）mm, normal ejection fraction for 0.65±0.08, N/C〈 2. The LVNC complication in Typical group presented as 11 cases with arrhythmia, 4 with coronary artery disease, 43 with mitral regurgitation, 26 with tricuspid regurgitation, 12 with pericardial effusion and 1 with lacunar cerebral infarction. Conclusion： LVNC hasn＇t fully understood yet in our daily clinical practice, echocardiography had the special value in LVNC diagnosis, while there certain technical issues should be further studied.