心室预激性扩张型心肌病  

Accessory pathway induced dilated cardiomyopathy

作　　者：金梅[1] 戴辰程[1] 霍玉峰[1] 

机构地区：[1]首都医科大学附属北京安贞医院小儿心脏科,100029

出　　处：《中华实用儿科临床杂志》2017年第1期7-9,共3页Chinese Journal of Applied Clinical Pediatrics

摘　　要：心室预激性扩张型心肌病是新近提出的一种全新的疾病诊断名称，是由心室预激造成左心室心肌电-机械兴奋异常而引发心室重构、心功能降低所致，以扩张型心肌病为主要表现，由右侧显性旁路（B型预激）所致。其除了具备扩张型心肌的诊断条件外，尚具备以下特点：1.除外心动过速性心肌病及其他继发性扩张型心肌病；2.体表12导联心电图提示显性预激，且为右侧旁道；3.M型超声、组织多普勒或二维超声应变分析发现心室收缩不同步现象，可伴左心室扩大及左心室射血分数下降。心室预激性扩张型心肌病为射频消融适应证，预后良好。对于婴幼儿来说，基于安全性考虑，可以考虑应用抑制旁路前传的抗心律失常药物治疗。Accessory pathway - induced dilated cardiomyopathy is a new diagnosis proposed recently. Pre - excitation of part of the myocardium may mediate electrical and mechanical dyssynchrony, which will result in decreased left ventricular systolic function and increased diameter of left ventricle in patients with right - sided overt accessory pathways（ type B ventricular preexcitation）. Its features are listed as follows：（ 1 ）Incessant and prolonged tachyarrhythmia never happened. Tachycardiomyopathy and other causes of dilated cardiomyopathy are excluded. （2） Right - sided overt accessory pathways are shown by electrocardiogram. （3）Echocardiography indicates dyssynchronous left ventricle contraction, decreased left ventricular systolic function and increased diameter of left ventricle. Normal interventricular septal motion, recovered left ventricular and reversed left ventrieular remodeling can be realized by radiofrequency ablation with a good prognosis. To infant patients, taking anti arrhythmia drugs to inhibit the conduction of the accessory pathway was recommended.

关 键 词：心室预激 扩张型心肌病 不同步 

分 类 号：R725.4[医药卫生—儿科]