预激性心肌病患儿的超声心动图特点分析

Echocardiographic Characteristics of Pediatric Pre-excitation Cardiomyopathy Patients

目的:总结分析预激性心肌病患儿的超声心动图特点。方法:纳入2017年9月至2019年2月在北京儿童医院进行射频导管消融治疗,伴有室间隔运动异常且在其随访过程中左心室形态及功能恢复正常的9例预激性心肌病患儿,行射频导管消融时年龄2岁1个月至9岁,中位年龄5岁。分析患儿术前M型及二维超声心动图、彩色多普勒、组织多普勒及心脏同步性等多项指标,对该病的超声心动图特点进行总结。结果:预激性心肌病患儿超声心动图呈现多种以室间隔矛盾运动为基础的特征性改变,包括:(1)M型及二维超声心动图显示室间隔异常运动;(2)左心室扩大,球形度增大;(3)彩色多普勒显示左心室心腔内血流为涡流;(4)二维斑点追踪技术对左心室纵向应变分析显示室间隔应变曲线异常;(5)双心室运动及左心室整体运动不协调。结论:预激性心肌病患儿的超声心动图呈现以室间隔运动异常为主的多种特征性改变。

Objectives:To analyze the echocardiographic characteristics of pediatric pre-excitation cardiomyopathy patients in order to improve its clinical recognition and diagnosis.Methods:Nine patients with pre-excitation cardiomyopathy were included.Patients aged from 2 years to 9 years(median 5 years).All patients underwent radiofrequency ablation from September 2017 to February 2019 in Beijing Children's Hospital.Echocardiographic findings of these patients were analyzed.Results:Echocardiographic characteristics of patients included:(1)Abnormal ventricular septal motility in 2-D and M-mode echocardiography.(2)Increased left ventricular diameter and sphericity.(3)Turbulent flow within left ventricle as shown by color Doppler imaging.(4)Abnormal left ventricular longitudinal strain of ventricular septal segments observed by 2-D speckle tracking analysis.(5)Interventricular and intraventricular desynchrony.Conclusions:A number of characteristic echocardiography findings,especially the abnormal ventricular septal segmental motion,could be evidenced in these pediatric patients with pre-excitation cardiomyopathy.