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目的:研究短暂性左心室球形性综合征(TLVABS)的临床特征及预后。方法:复习2005-09到2008-08行冠状动脉造影检查所有患者的临床及影像学资料,确诊15例TLVABS,并进行临床随访。结果:15例患者中男性2例(13.3%),女性13例(86.7%),平均年龄(63.60±10.43)岁,73.3%(11/15)发病前有应激事件,主要临床表现为胸痛(93.3%)及呼吸困难(20.0%)。60.0%(9/15)患者起初的心电图表现为ST段抬高,15例患者肌钙蛋白均轻度升高,86.7%(13/15)表现为伴心尖受累的典型TLVABS,13.3%(2/15)为心尖活动正常的非典型TLVABS。1例(6.7%)有左心室流出道梗阻。住院期间无严重并发症及死亡。14例(93.3%)接受随访,1例(6.7%)失访。平均随访16.95±9.38(5.5～31.5)月,1例(7.1%)复发,1例(6.7%)死于车祸,无心源性死亡及慢性心力衰竭。结论:TLVABS的临床表现酷似急性心肌梗死,有明显应激因素,但预后良好。
Objective: To study the clinical characteristics and prognosis of transient left ventricular syndrome (TLVABS). Methods: The clinical and imaging data of all patients who underwent coronary angiography from 2005 to 2008 were retrospectively reviewed. Totally 15 cases of TLVABS were confirmed and followed up clinically. Results: Among the 15 patients, there were 2 males (13.3%) and 13 females (86.7%), with an average age of 63.60 ± 10.43 years and 73.3% (11/15) before onset of stress. The main clinical manifestations were chest pain (93.3%) and dyspnea (20.0%). In 60.0% (9/15) of the patients, the electrocardiogram showed ST-segment elevation at first, and the troponin in all 15 patients was slightly elevated. The typical TLVABS with apical involvement was 86.7% (13/15), 13.3% / 15) apex atypical TLVABS. One patient (6.7%) had left ventricular outflow tract obstruction. No serious complications and death during hospitalization. Fourteen cases (93.3%) were followed up and one case (6.7%) were lost. The average follow-up was 16.95 ± 9.38 (5.5-31.5) months. One patient (7.1%) recurred and one patient (6.7%) died of car accident without cardiac death and chronic heart failure. Conclusion: The clinical manifestations of TLVABS resemble acute myocardial infarction with obvious stress factors, but the prognosis is good.