应用超声二维斑点追踪技术测量二尖瓣环位移评价冠心病患者左心功能  

Assessment of left ventricular systolic function in coronary heart disease using mitral annulus displacement by speckle tracking imaging

作　　者：王志强[1] 管琰[2] 刘娴[1] 孙丽娜 陈勇军[2] 

机构地区：[1]常熟市第五人民医院心内科,江苏省215500 [2]常熟市第一人民医院功能科

出　　处：《中华临床医师杂志（电子版）》2011年第16期4718-4721,共4页Chinese Journal of Clinicians(Electronic Edition)

摘　　要：目的应用超声斑点追踪二尖瓣环位移技术(MAD)快速评价冠心病患者左心室收缩活动异常。方法随机入组63例,其中健康志愿者43例(对照组),冠状动脉造影确诊的冠心病患者20例(病例组)。所有研究对象存储心尖四腔观、心尖二腔观二维图像,以Simpson法测量左心室舒张末容积、左心室收缩末容积和左心室射血分数(LVEF)。并应用Qlab8.0工作站,自动获取二尖瓣环侧壁(MADlat)、后室间隔(MADsep)二个位点的收缩期最大位移以及二尖瓣环连线中点处MAD(MADmid),并计算MADmid与左心室舒张末长径百分比(MADmid%)。分析各MAD参数与LVEF之间的关系。结果所有研究者MADsep、MADlat、MADmid及MADmid%均与LVEF正相关,相关系数分别为0.69(P=0.0000),0.54(P=0.0000),0.66(P=0.0000),0.72(P=0.0000)。病例组MADsep、MADlat、MADmid及MADmid%均显著小于对照组[对照组vs.病例组MADsep:(11.95±2.43)mmvs.(8.46±3.29)mm,P=0.00007;MADlat:(13.38±3.09)mmvs.(9.58±2.18)mm,P=0.00006;MADmid:(12.95±2.66)mmvs.(9.09±2.65)mm,P=0.00003;MADmid%:15.84±3.25vs.10.28±3.60,P=0.00001]。结论应用超声二维斑点追踪技术测定MAD与LVEF存在良好的相关性,且能快速、稳定地评价冠心病患者左心室收缩活动异常。Objective To evaluate left ventricular systolic function in coronary heart disease(CHD)patients using mitral annulus displacement(MAD)by speckle tracking imaging(STI).Methods Forty-three healthy volunteers and twenty CHD patients were randomly enrolled.All the participants received routine echocardiography exams and their apical four-chamber view and two-chamber view images were recorded.LVEDV,LVESV and LVEF were calculated by biplane Simpson method.MAD of interventricular septum(MADsep),left ventricular lateral wall(MADlat)and middle point of mitral annulus(MADmid)were measured offline in Qlab 8.0 workstation.MADmid% was defined as MADmid divided by left ventricular end-diastolic diameter.The correlation between MAD indexes and LVEF was also explored.Results(1)MADsep,MADlat,MADmid amd MADmid%showed significantly positive correlations with LVEF [r=0.69(P=0.0000),r=0.54(P=0.0000),r=0.66(P=0.0000),r=0.72(P=0.0000),respectively].(2)MAD indexes were significantly smaller in CHD patients than in healthy volunteers [control group vs.patient group:MADsep:(11.95±2.43) mm vs.(8.46±3.29) mm,P=0.00007;MADlat:(13.38±3.09) mm vs.(9.58±2.18) mm,P=0.00006;MADmid:(12.95±2.66) mm vs.(9.09±2.65) mm,P=0.00003;MADmid%:15.84±3.25 vs.10.28±3.60,P=0.00001].Conclusions MAD by STI showed a great correlation with biplane-Simpson LVEF.It can be a rapid and stable index for assessment of left ventricular systolic function in CHD patients.

关 键 词：超声心动描记术 心室功能 左 二尖瓣环位移 斑点追踪 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]