Медицинская литература. Новинки

 

 

 

 

 

 

Аневризмы левого желудочка как осложнение некомпактного миокарда у детей

Вы можете загрузить полный текст статьи в формате pdf

Эхокардиографическое обследование по стандартной методике было проведено 55 детям с некомпактным миокардом. Диагноз “некомпактный миокард” устанавливался на основании ультразвуковых критериев, разработанных Chin T.K. et al. (1990) и Jenni R. et al. (2007). У 9 из 55 обследованных пациентов были выявлены аневризмы левого желудочка. Аневризмы локализовались в области апикальноперегородочного, апикальнобокового и среднебокового сегментов. Во всех случаях в области аневризм определялось более выраженное нарушение сократимости миокарда, чем в остальных его участках. Полость аневризмы, а также сообщение с полостью левого желудочка визуализировались как в момент диастолы, так и в момент систолы желудочка. У одного пациента в области аневризмы был выявлен тромб. Аневризмы левого желудочка являются нередким осложнением некомпактного миокарда у детей (16%). При выявлении аневризм левого желудочка у детей в диагностический поиск должен быть включен диагноз “некомпактный миокард”.

Ключевые слова:
эхокардиография, не компактный миокард, аневризмы левого желудочка, дети.

Литература:
1. Richardson P., McKenna W., Bristow M. et al.
Report of the 1995 World Health Organi
zation/International Society and Federation of
Cardiology Task Force on the Definition and
Classification of cardiomyopathies // Circulation.
1996. V. 93. № 5. P. 841–842.
2. Maron B.J., Towbin J.A., Thiene G. et al.
Contemporary definitions and classification of the
cardiomyopathies: an American Heart Association
Scientific Statement from the Council on Clinical
Cardiology, Heart Failure and Transplantation
Committee; Quality of Care and Outcomes Research
and Functional Genomics and Translational Biology
Interdisciplinary Working Groups; and Council on
Epidemiology and Prevention // Circulation. 2006.
V. 113. № 14. P. 1807–1816.
3. Dusek J., Ostadal B., Duskova M. Postnatal per
sistence of spongy myocardium with embryonic
blood supply // Arch. Pathol. 1975. V. 99. № 6.
P. 312–317.
4. Bione S., D’Adamo P., Maestrini E. et al. A novel
Xlinked gene, G4.5. is responsible for Barth syndrome // Nat. Genet. 1996. V. 12. № 4. P. 385–389.
5. SasseKlaassen S., Gerull B., Oechslin E. et al.
Isolated noncompaction of the left ventricular
myocardium in the adult is an autosomal dominant
disorder in the majority of patients // Am. J. Med.
Genet. 2003. V. 119A. № 2. P. 162–167.
6. Stollberger C., Finsterer J., Blazek G. Left ventricular hypertrabeculation/noncompaction and association with additional cardiac abnormalities and
neuromuscular disorders // Am. J. Cardiol. 2002.
V. 90. № 8. P. 899–902.
7. Chin T.K., Perloff J.K., Williams R.G. et al.
Isolated noncompaction of left ventricular
myocardium. A study of eight cases // Circulation.
1990. V. 82. № 2. P. 507–513.
8. Jenni R., Oechslin E.N., van der Loo B. Isolated
ventricular noncompaction of the myocardium in
adults // Heart. 2007. V. 93. № 1. P. 11–15.
9. Lilje C., Razek V., Joyce J.J. et al. Complications of
noncompaction of the left ventricular myocardium
in a paediatric population: a prospective study //
Eur. Heart J. 2006. V. 27. № 15. P. 1855–1860.
10. Alhabshan F., Smallhorn J.F., Golding F. et al.
Extent of myocardial noncompaction: comparison
between MRI and echocardiographic evaluation //
Pediatr. Radiol. 2005. V. 35. № 11. P. 1147–1151.
11. Oechslin E.N., Attenhofer Jost C.H., Rojas J.R. et
al. Longterm followup of 34 adults with isolated
left ventricular noncompaction: a distinct cardiomyopathy with poor prognosis // J. Am. Coll.
Cardiol. 2000. V. 36. № 2. P. 493–500.
12. McMahon C.J., Pignatelli R.H., Nagueh S.F. et al.
Left ventricular noncompaction cardiomyopathy
in children: characterisation of clinical status
using tissue Dopplerderived indices of left ventricular diastolic relaxation // Heart. 2007. V. 93. № 6.
P. 676–681.
13. Yun H., Zeng M.S., Jin H., Yang S. Isolated non
compaction of ventricular myocardium: a magnetic
resonance imaging study of 11 patients // Korean
J. Radiol. 2011. V. 12. № 6. P. 686–692.
14. Ionescu C.N., Turcot D. Left ventricular noncompaction and aneurysm revealed by left ventriculography // Catheter. Cardiovasc. Interv. 2012. V. 80.
№ 1. P. 109–111.
15. Sato Y., Matsumoto N., Yoda S. et al. Left ventricular aneurysm associated with isolated noncompaction of the ventricular myocardium // Heart
Vessels. 2006. V. 21. № 3. P. 192–194.
16. Glower D.D., Lowe J.E. Left ventricular aneurysm // Cardiac Surgery in the Adult / Ed. by
Cohn L.H., Edmunds L.J. NY: McGrawHill, 2003.
P. 771–788.
17. Srichai M.B., Hecht E.M., Kim D.C., Jacobs J.E.
Ventricular diverticula on cardiac CT: more common than previously thought // AJR. 2007. V. 189.
№ 1. P. 204–208.
18. Mayer K., Candinas R., Radounislis C., Jenni R.
Congenital left ventricular aneurysms and diverticula: clinical findings, diagnosis and course //
Schweiz. Med. Wochenschr. 1999. V. 129. № 35.
P. 1249–1256.
19. Ercan A., Senkaya I., Semizel E., Cil E. Left ventricular aneurysm in a 4yearold boy // Tex. Heart
Inst. J. 2005. V. 32. № 4. P. 614–615.
20. Jedlinski I., Judyta Schlaffke J., Michalski M. et
al. Noncompaction of left ventricular myocardium
connected with double ventricular septal defect //
Polski Przeglad Kardiologiczny. 2002. V. 4. № 4.
P. 401–404.
21. Lopez L., Colan S.D., Frommelt P.C. et al. Recommendations for quantification methods during the
performance of a pediatric echocardiogram:
a report from the Pediatric Measurements Writing
Group of the American Society of Echocardio
graphy Pediatric and Congenital Heart Disease
Council // J. Am. Soc. Echocardiogr. 2010. V. 23.
№ 5. P. 465–495.
22. Сугак А.Б., Дворяковский И.В., Дворяков
ская Г.М. Новый способ расчета эхокардиографических параметров левого желудочка сердца
у детей // Российский педиатрический журнал.
2009. № 3. С. 10–14.
23. Eidem B.W., McMahon C.J., Cohen R.R. et al.
Impact of cardiac growth on Doppler tissue imaging
velocities: a study in healthy children // J. Am.
Soc. Echocardiogr. 2004. V. 17. № 3. P. 212–221.
24. Kirby A., Davies R. Developmental Coordination
Disorder and Joint Hypermobility Syndrome –
overlapping disorders? Implications for research
and clinical practice // Child Care Health Dev.
2007. V. 33. № 5. P. 513–519.

Left Ventricular Aneurysm as the Complication of Myocardial Noncompaction in Children

55 children with noncompaction of myocardium underwent standard echocardiography. Diagnosis of myocardial noncompaction was done according to the ultrasound criteria which were developed by Chin T.K. et al. (1990) and Jenni R. et al. (2007). Left ventricular aneurysms were revealed in 9 of 55 patients. They localized in apical septal, apical lateral, and mid lateral segments. In all cases more significant disorders of myocardium contractility were detected in aneurysm location. Aneurysm and its connection with left ventricle visualized at ventricle diastole and ventricle systole as well. Thrombus in aneurysm was revealed in one patient. Left ventricle aneurysm is the frequent complication of myocardial noncompaction in children (16%). Diagnosis of myocardial noncompaction should be included in diagnostic algorithm in children with left ventricle aneurysms.

Keywords:
echocardiography, noncompaction of myocardium, left ventricular aneurysms, and children.