关键词: 扩张型心肌病, 心脏舒张功能, 小儿超声心动图

Abstract:

Objective This study sought to evaluate the left ventricular restrictive diastolic dysfunction(RDD) in children with dilated cardiomyopathy(DCM) and its clinical implications.Methods The diastolic function was assessed in 42 children with DCM(21 male,21 female;aged 1～14 years) and 42 age and gender matched normal children by using 2-dimension and Doppler echocardiography.The mitral peak flow velocities during early filling(E wave) and during atrial contraction(A wave),the ratio of E and A velocity,the deceleration time of the E wave(DT) and isovolumic relaxation time were measured.Pulmonary arterial pressure was assessed by measurement of the tricuspid regurgitant velocity.Results DT was shortened〔(88±27)ms vs(128±40)ms,P<0.01〕,the ratio of E and A velocity increased and isovolumic relaxation time shortened in children with DCM as compared with normal controls,indicating the left ventricular RDD in children with DCM.According to normal criteria, 20(48%) patients had RDD,including 16(38%) with a shortened DT and 14(33%) with an increased ratio of E and A velocity.RDD was related to the dilation of left atrium and ventricle,the elevation of pulmonary arterial pressure and the gradation of cardiac function,but not related to left ventricular ejection fraction.The patients with RDD had higher NY cardiac function scores.During the follow-up period of 1～51 months(mean 26 months),7(35%),3(15%) and 10(50%) of the 20 patients with RDD died,deteriorated or unchanged,respectively;while 1(5%),2(9%),5(23%) and 14(63%) died,deteriorated,unchanged or improved,respectively,in patients without RDD((P<)(0.01)).Conclusion Among children with DCM,48% had RDD,which was associated with the NY cardiac function scores and prognosis.The identification of left ventricular RDD by Doppler echocardiography is helpful for predicting prognosis.

Key words: cardiomyopathy dilated, cardiac function diastolic, echocardiography children