Value of echocardiography in diagnosis of severe myocarditis
Objective To explore the application value of echocardiography in the diagnosis and treatment of adult severe myocarditis(SM),and to provide an important reference for timely and effective clinical diagnosis and the application of extracorporeal membrane oxygen-ation(ECMO)adjuvant therapy.Methods A total of 29 SM patients hospitalized in the General Hospital of Northern Theater Com-mand from September 2018 to December 2021 were selected as the critical group,and then divided into ECMO group(n =9)and non-ECMO group(n =20)according to whether or not they were treated with ECMO.Another 30 patients with normal physical examination results in the same age group were selected as the healthy group.The ultrasound parameters of the critical and healthy groups,as well as the ECMO and non-ECMO groups were compared to further analyze the characteristics of patients requiring ECMO treatment.The ultrasound parameters included left atrial diameter(LAD),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),ventricular septum(IVS),left ventricular posterior wall thickness(LVPW),ventricular wall thickening rate,left ventricular ejection fraction(LVEF),mitral valve early diastolic peak velocity(Em),tricuspid valve early diastolic peak velocity(Et),mitral valve late diastolic peak velocity(Am),late diastolic peak velocity of tricuspid valve(At),early diastolic peak velocity of mitral ring(Em′),early diastolic peak velocity of mitral ring(Et′),early diastolic peak velocity of mitral ring(Ei′),late diastolic peak veloci-ty of mitral ring(AM′),late diastolic peak velocity of tricuspid ring(At′),interventricular septum late diastolic peak velocity(Ai′),mitral peak systolic peak velocity(Sm′),tricuspid peak systolic peak velocity(St′),ventricular septal peak systolic peak velocity(Si′),Em/Am,Em/Em′,Em/Ei′,Et/Et′,pulmonary artery systolic blood pressure(SPAP).Results In the early stage of SM,the ul-trasonography showed that the left ventricular echo was decreased in different degrees,the rate of wall thickening and the amplitude of motion were decreased diffusingly.LAD,IVS,LVEDd,LVESd,heart rate,SPAP,Em/Am,Em/Em′,Em/Ei′,Em/Em′,EM/Ei′,Am,Am,At′,Ai′,Sm′,St′,Si′in the critical group were higher than those in the healthy group,while LVEF,EM′,Et′,EI′,AM,AM′,AT′,AI′,SM′,ST′,SI′were lower than those in the healthy group.The differences were statistically significant(P<0.05).LVEDd and LVEF in ECMO group were significantly lower than those in non-ECMO group,the difference was statistically significant(P<0.05),and the systolic peak velocity at the flap ring of both groups was significantly lower than the normal level,and the Si′in the ECMO group was lower than that in the non-ECMO group,with statistical significance(P<0.05).Conclusion Echocardiography plays an important role in the diagnosis and treatment of SM by rapidly diagnosing,judging the severity and continuously monitoring the course of ECMO treatment in the early stage of the onset of SM.
NETL
NSTL
万方数据
