Retrospective analysis of etiology and echocardiography diagnosis in 2086 cases with right heart enlargement

doi:10.3877/cma.j.issn.1672-6448.2016.11.014

Abstract

Abstract:

Objective

To analysis the pathogenies which result in the simple enlargement of right heart, to provide ideas about the Echocardiograph diagnosis of this disease.

Methods

This study retrospectively analyzed 2086 patients diagnosed as right heart enlargement by Echocardiography in the Affiliated Union Hospital of Huazhong University of Science and Technology from January 2013 to May 2015, include the characteristics of echocardiography image and clinical data, then summarized the clinical pathogenies of right heart enlargement.

Results

A total of 2086 cases were collected, 1098 cases were congenital heart diseases (52.64%), including 804 cases of simple congenital heart diseases (38.54%), ASD 674 (32.31%), 294 cases of complex congenital heart diseases (14.09%). Three hundred and seventy three cases of secondary enlargement after operation of Congenital heart diseases and valvular diseases (17.88%). One hundred and forty cases of pulmonary heart diseases (6.71%). One hundred and thirteen cases of valvular heart disease (5.42%), including 57 cases of three tricuspid valve diseases (2.73%), 36 cases of rheumatic heart diseases (1.73%), 21 cases of non-rheumatic heart diseases (1.01%), 42 cases of sinus of Valsalva aneurysm ruptured into the right heart (2.01%), 8 cases of combined valvular diseases (0.96%), 4 cases of pulmonary valve regurgitation (0.19%). 30 cases of cardiomyopathy (1.44%), mainly of arrhythmogenic right ventricular cardiomyopathy (ARVC) and noncompaction of right ventricular myocardium (NVM) . Twenty one cases of coronary heart diseases (1.00%). Twenty cases of Coronary artery fistula into the right heart, (0.96%). Forteen cases of pulmonary embolism (0.67%). Forteen cases of arrhythmia (0.67%). Two hundred and sixty five cases of the other reasons (12.51%).

Conclusions

The main clinical pathogeny which results in simple enlargement of right heart was simple congenital heart disease, especially ASD, followed by the secondary enlargement after operation of congenital heart diseases and valvular heart diseases, valvular heart diseases, cardiomyopathy and coronary heart disease et al.

Key words: Echocardiography, Right heart enlargement, Diagnosis thinking

Bin Wang, Mingxing Xie, Li Zhang. Retrospective analysis of etiology and echocardiography diagnosis in 2086 cases with right heart enlargement[J]. Chinese Journal of Medical Ultrasound (Electronic Edition), 2016, 13(11): 865-871.

/ / Recommend

Add to citation manager EndNote|Ris|BibTeX

URL: https://chaosheng.cma-cmc.com.cn/EN/10.3877/cma.j.issn.1672-6448.2016.11.014

https://chaosheng.cma-cmc.com.cn/EN/Y2016/V13/I11/865

Figures/Tables 4

References 25

[1]	Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: A Report from the American society of echocardiography [J]. J Am Echocardiogr, 2010, 23(7): 685-713.
[2]	Haddad F, Doyle R, Murphy DJ, et al. Right ventricular function in cardiovascular disease, part II: pathophysiology, clinical importance,and management of right ventricular failure [J]. Circulation, 2008, 117(13): 1717-1731.
[3]	孙妍, 裴金凤, 陈杰, 等. 超声心动图诊断完全性心内型肺静脉异位引流一例[J/CD]. 中华医学超声杂志:电子版, 2013, 10(9): 780-781.
[4]	Haddad F, Doyle R, Murphy DJ, et al. Right ventricular function in cardiovascular disease, part Ⅱ: pathophysiology, clinical importance,and management of right ventricular failure [J]. Circulation, 2008, 117(13): 1717-1731.
[5]	Yao GH, Deng Y, Liu Y, et al. Echocardiographic measurements in normal chinese adults focusing on cardiac chambers and great arteries: a prospective, nationwide, and multicenter study [J]. J Am Soc Echocardiogr, 2015, 28(5): 570-579.
[6]	Wood P. The Eisenmenger syndrome or pulmonary hypertension with reversed central shunt [J]. Br Med J, 1958, 2(5098): 701-709.
[7]	McGoon M, Gutterman D, Steen V, et a1. Screening, early detection, and diagnosis of pulmonary arterial hypertension:ACCP evidence-based clinical practice guidelines [J]. Chest, 2004, 126(1 Suppl):14S-34S.
[8]	Meht SR, Eikelboom JW, Natarajan MK, et al. Impact of right ventricular involvement on mortality in patients with inferior myocardial infarction [J]. J Am Coll Cardiol, 2001, 37(1): 37-43.
[9]	Burgess MI, Mogulkoc N, Bright-Thomas RJ, et al. Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease [J]. J Am Soc Echocardiogr, 2002, 15(6): 633-639.
[10]	Quiroz R, Kuher N, Schoepf UJ, et al. Right ventricular enlargement on chest computed tomography:prognostic role in acute pulmonary embolism [J]. Circulation, 2004, 109(20): 2401-2404.
[11]	Fremont B, Pacouret G, Jacobi D, et al. Prognostic value of echocardiographic right/left ventricular end-diastolic diameter ratio in patients with acute pulmonary embolism:results from a monocenter registry of 1416 patients [J]. Chest, 2008, 133(2): 358-362.
[12]	Burgess MI, Mogulkoc N, Bright-Thomas RJ, et al. Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease [J]. J Am Soc Echocardiogr, 2002, 15(6): 633-639.
[13]	Quiroz R, Kucher N, Schoepf UJ, et al. Right ventricular enlargement on chest computed tomography: prognostic role in acute pulmonary embolism [J]. Circulation, 2004, 109(20): 2401-2404.
[14]	Elliott P, Andersson B, Arbustini E, et al.Classification of the cardiomyopathies:a position statement from European society of cardiology working group on myocardial diseases [J].Eur Heart J, 2008, 29: 270-276.
[15]	Sen-Chowdhry S, Lowe MD, Sporton SC, et a1. Arrhythmogenic right ventricular cardiomyopathy: clinical presentation, diagnosis, and management [J]. Am J Med, 2004, 117(9): 685-695.
[16]	孔令秋, 康彧, 唐红, 等. 超声诊断致心律失常性右心室心肌病的临床价值再评价 [J]. 中华超声影像学杂志, 2013, 22(9): 737-740.
[17]	Lopaschuk GD, Jaswal JS. Energy metabolic phenotype of the cardiomyocyte during development, differentiation, and postnatal maturation [J]. J Cardiovasc Pharmacol, 2010, 56(2): 130-140.
[18]	Hoedemaekers YM, Caliskan K, Michels M. et al. The importance of genetic counseling, DNA diagnostics, and cardiologic family screening in left ventricular noncompaction cardiomyopathy [J]. Circ Cardiovasc Genet, 2010, 3(3): 232-239.
[19]	Finsterer J, Stöllberger C. Ultrastructural Findings in Noncompaction Prevail with Neuromuscular Disorders [J]. Cardiology, 2013, 126(4): 219-223.
[20]	Dubourg B, DʹHeré B, de Vecchi C, et al. Incidental diagnosis of a familial left ventricular noncompaction on a chest CT angiography [J]. Diagn Interv Imaging, 2014, 95(1): 91-93.
[21]	Statile CJ, Taylor MD, Mazur W, et al. Left ventricular noncompaction in Duchenne muscular dystrophy [J]. J Cardiovasc Magn Reson, 2013, 15(1): 67.
[22]	Rudski LG, Lai WW, Afilalo J, et al. Guidelines for the echocardiographic assessment of the right heart in adults: A Report from the American society of echocardiography [J]. J Am Echocardiogr, 2010, 23(7): 685-713.
[23]	Vonghia L, Leggio L, Ferrulli A, et al. Acute alcohol intoxication [J]. Eur J Inter Med, 2008, 19(8): 561-567.
[24]	Burgess MI, Mogulkoc N, Bright-Thomas RJ, et al. Comparison of echocardiographic markers of right ventricular function in determining prognosis in chronic pulmonary disease [J]. J Am Soc Echocardiogr, 2002, 15(6): 633-639.
[25]	Haddad F, Hunt SA, Rosenthal DN, et al. Right ventricular function in cardiovascular disease, part I: anatomy, physiology, aging, and functional assessment of the right ventricle [J]. Circulation, 2008, 117(11): 1436-1448.

分类		例数	百分比[%（例/例）]
乏氏窦瘤破入右心		42	2.01（42/2086）
?	无冠窦破入右心房	15	?
?	右冠窦破入右心室	27	?
三尖瓣疾病		21	1.01（21/2086）
?	赘生物（单纯三尖瓣）	15	?
?	脱垂	6	?
肺动脉瓣关闭不全		4	0.19（4/2086）
联合瓣膜疾病（三尖瓣合并肺动脉瓣）		8	0.38（8/2086）

分类		例数	百分比[%（例/例）]
乏氏窦瘤破入右心		42	2.01（42/2086）
?	无冠窦破入右心房	15	?
?	右冠窦破入右心室	27	?
三尖瓣疾病		21	1.01（21/2086）
?	赘生物（单纯三尖瓣）	15	?
?	脱垂	6	?
肺动脉瓣关闭不全		4	0.19（4/2086）
联合瓣膜疾病（三尖瓣合并肺动脉瓣）		8	0.38（8/2086）

Please choose a citation manager

Content to export