Echocardiographic morphology：a comparison between patients with chronic Keshan disease and ischemic cardiomyopathy / 中华地方病学杂志

ABSTRACT

Objective To investigate the characteristics of chronic Keshan disease (CKD) and ischemic cardiomyopathy ( ICM ) and provide a basis for differential diagnosis . Methods Forty-two cases of CKD were randomly sampled from 6 Keshan disease districts in Sishui, Zoucheng, Juxian, Wulian, Yishui and Qingzhou Counties of Shandong Province, as CKD group. Thirty-one cases of ICM were selected from Qianfushan Hospital as ICM group. Echocardiography was used to analyze the cardiac morphology , hemodynamic and function. Results Left atrial internal diameter(LA), left ventricular(LV), end-diastolic internal diameter(LVd), right ventricular diameter(RV) and right atrial transverse diameter(RAtd) of the CKD group[(45.14 ± 6.93),(68.48 ± 6.24),(28.90 ± 3.14),(52.79 ± 6.62)mm] were higher than those of ICM group[(40.68 ± 5.12),(60.55 ± 4.07),(24.35 ± 2.12), (47.68 ± 8.53)mm , t = 3.03, 6.55, 7.38, 2.88, all P < 0.01]. In CKD group, several atrioventricular carities were enlarged, and the ventricular wall tended to become thin. In ICM group, left atrioventricular cavities were enlarged, and the apex of LV was thin spherical. The LV ejection fraction(LVEF) and fractional shortening of LV (LVFS) of the CKD group [(40.50 ± 10.68)%, (22.81 ± 6.24)%] were lower than those of the ICM group [(54.61 ± 6.58)%, (30.71 ± 4.29)%, t = - 6.957, - 5.976, all P < 0.01]. Diffuse hypokinetic motion of LV reduced in 85.7%(36/42) of CKD patients, and 83.9%(26/31) of ICM patients had segmental LV dyskinesia. Slight regurgitation of single valve was common in ICM group , but several regurgitation of multiple valves were more common in CKD group. Conclusion Echocardiography is a valuable noninvasive technology for differentiating CKD and ICM.