Advanced Ultrasound in Diagnosis and Therapy ›› 2022, Vol. 6 ›› Issue (2): 72-94.doi: 10.37015/AUDT.2022.210021
• Consensus and Guidelines • Previous Articles
Echocardiography Group of Ultrasound Medicine Branch in Chinese Medical Association, Echocardiography Committee of Cardiovascular Branch in Chinese Medical Association
Received:
2021-08-07
Revised:
2021-08-24
Accepted:
2021-09-04
Online:
2022-06-30
Published:
2022-06-26
Contact:
Department of Ultrasonography, Shandong University Qilu Hospital, 107 Wenhua Xi Lu, Lixia District, Jinan, Shandong, China. M Zhang, e-mail: daixh@vip.sina.com; Y Zhang, e-mail: yun-zhang@163.com; Department of Ultrasonography, The First Affiliated Hospital of Xinjiang Medical University, 137 Liushan South Road, Xincheng District, Urumqi, Xinjiang, China. YM Mu, e-mail: mym1234@126.com.,
Echocardiography Group of Ultrasound Medicine Branch in Chinese Medical Association, Echocardiography Committee of Cardiovascular Branch in Chinese Medical Association . Guidelines for Echocardiographic Diagnosis of Cardiomyopathy: Recommendations from Echocardiography Group of Ultrasound Medicine Branch in Chinese Medical Association, Echocardiography Committee of Cardiovascular Branch in Chinese Medical Association. Advanced Ultrasound in Diagnosis and Therapy, 2022, 6(2): 72-94.
Table 2
Classification of RCM"
Classification | Disease | |
---|---|---|
Myocardial RCM | Non-infiltrative | Idiopathic, scleroderma, pseudoxanthoma elasticum |
Infiltrative | Amyloidosis, sarcoidosis, sarcomatous change, Gaucher disease, | |
Storage | Hemochromatosis, Fabry disease, glycogen storage disease | |
Endomyocardial RCM | Occlusive | Endomyocardial fibrosis, Löffler endocarditis |
Non-occlusive | Carcinoid heart disease, malignant infiltration, iatrogenic (drug, radiation) |
Table 3
key points to differentiate RCM from constrictive pericarditis"
Key points | CP | RCM |
---|---|---|
History | History of pericardial effusion, developing slowly | Unknown etiology, developing rapidly |
Peri- or endocardium | Pericardial thickening and calcification | Endocardial thickening and echo enhancement |
Atria | Slight enlarged | Usually significantly enlarged |
Interventricular septum motion | Septal swing with respiration, M-mode show a notch or bounce in early diastole | Not obvious |
Mitral inflow variation | Obvious with respiratory variation in mitral E wave velocity with difference >25% | Not obvious |
TDI | Mitral annulus average velocities e’>8 cm/s, e’septal >e’lateral | Mitral annulus average velocities e’<8 cm/s |
Hepatic venous flow variation | End diastolic reverse flow velocity/forward flow velocity in expiration≥0.8 | Velocity of reverse flow increased in inspiration |
Figure 1
Left ventricular long-axis view: Left atrium and left ventricle are significantly enlarged, both ventricular septum and left ventricular posterior wall become thinner, and the opening of the mitral valve becomes smaller during diastole, forming a so-called "large cardiac chambers, small opening"."
Figure 2
The apical four-chamber view: left ventricle is significantly enlarged and becomes spherical with longitudinal diameter of 73mm and transverse diameter of 62mm. The ratio of longitudinal to transverse diameter as spherical index (SI) is 1.2, which was less than the reference value of 1.5. The ventricular septum and left ventricular lateral wall become thinner with smoky echoes in left ventricle, suggesting slow blood flow."
Figure 5
Apical five-chamber view: the blood flow velocity of LVOT increases during systole with the peak velocity of 3.1m/s and the maximum pressure difference is 37mmHg, the blood flow spectrum is negative high-velocity filling jet during systole, and the shape presents as single-peaked "dagger-like" change."
Table 4
Recommendation of diagnostic criteria"
Criteria | Items |
---|---|
Main criteria: Akinetic or hypokinetic right ventricular regional wall motion, or aneurysm, with one of the following presentations: | ①PLAX RVOT≥32 mm ( After BSA standardization: PLAX RVOT ≥ 19 mm/m2);a |
②PSAX RV0T≥36 mm ( After BSA standardization: PSAX RVOT ≥ 21 mm/m2);a | |
③RVFAC<35%.b | |
Secondary criteria: Akinetic or hypokinetic right ventricular regional wall motion, with one of the following presentations: | ① 29 mm ≤ PLAX RVOT< 32 mm (After BSA standardization: 16 mm/m2 ≤ PLAX RVOT < 19 mm/m2); |
② 32 mm ≤ PSAX RVOT < 36 mm (After BSA standardization: 18 mm/m2 ≤ PSAX RVOT < 21 mm/m2);a | |
③ Right ventricular basal diameter > 39 mm (female); or 42 mm (male); c | |
④ TAPSE ≤ 16 mm;b | |
⑤ RV GLS absolute value < 20%;b | |
⑥ 3D RVEF ≤ 44%;b | |
⑦ RMPI > 55%;b | |
⑧ Peak systolic velocity of tricuspid annulus (S') < 8 cm/s;c | |
⑨(Three-segment/six-segment model) Right ventricular mechanical dispersion (Standard deviation of time-to-peak of strain) > 25~ 30 ms.d |
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