25个ROI斑点追踪分析射血分数保留心力衰竭的左心室前壁局部心肌功能  

Analysis of Regional Myocardial Function of Anterior Wall of the Left Ventricle Patients with Heart Failure with Preserved Ejection Fraction Using Speckle-tracking Echocardiography

作　　者：郑东燕[1] 张宇辉[1] 韩勇[1] 郑建华[1] 刘怡[1] 陈明[1] 

机构地区：[1]同济大学附属东方医院心脏医学部,上海200120

出　　处：《生物医学工程学进展》2013年第3期168-172,共5页Progress in Biomedical Engineering

基　　金：浦东新区科技发展基金创新资金(NO.PKJ2010-Y16);上海市卫生局青年项目(NO.2010Y012);上海市浦东新区心血管疾病学科群项目(NO.PWZxkq2010-01)

摘　　要：目的运用多点取样的方法,分析左室前壁心肌上25个感兴趣区的应变与应变率,观察射血分数保留的心力衰竭者的额断面局部心肌功能变化。方法选择健康对照组40例,HFPEF患者43例。在左心室前壁心肌额断面采集25个ROI的斑点追踪所获的收缩期、舒张早期与舒张晚期的应变、应变率,并比较两组间的的差异。利用ROC曲线分析25个ROI斑点追踪矩阵取样法对HFPEF患者左心室前壁局部心肌功能异常的诊断价值。结果 HFPEF组的SRS、SRE及SRA均小于对照组,差异具有统计学上的显著性意义(P=0.000~0.002);SRS、SRE与EF、E/é之间存在良好的相关性(r=-0.787~0.396)。结论应用左心室前壁心肌额断切面以25个ROI的方法能够检出HFPEF患者的局部异常心肌功能,在分辨HFPEF患者心肌功能异常上有一定的临床参考价值。Objective This study was designed to measure myocardial strain and strain rate at the anterior wall( AW) of the left ventricle( LV) in a multiple sampling way at a coronal plane of LV in patients with heart failure with preserved ejection fraction( HFPEF) using speckle- tracking echocardiography( STI). Methods Forty- three patients with HFPEF and 40 healthy subjects were selected. Twenty- five regions of interest( ROI) on the AW were tracked by STI. Strain(),strain rates in systole( SRS),strain rates in early- diastole( SRE),strain rates in late- diastole( SRA) on 25 ROI were collected and mean value from 25 ROI was compared between the two groups. Then we analysis the correlations between ε,SRS,SRE,SRA and left ventricular function. The receiver operating characteristics( ROC) curve was constructed to determine optimal sensitivity and specificity of,SRS,SRE and SRA. Results The mean values of SRS,SRE and SRA from STI in the AW of LV were significantly decreased in group of HFPEF( P = 0. 000 ~ 0. 002). SRS and SRE correlated well with EF and E / é. The ROC curves showed that SRA is the best predictor of HFPEF patients. The area under receiver operating characteristics( AUC) curve of SRE was 0. 885,and its optimal cut- off for GLS was 1. 93,with a sensitivity of 87. 3%. AUC curve of SRS was0. 679,and its optimal cut- off for GLS was- 1. 95,with a specificity of 78. 3%. Conclusion Twenty- five sampling ROI by STI at a coronal plane of LV could be a valuable modality for detection of regional wall abnormal in patients with HFPEF.

关 键 词：超声心动图描记术 斑点追踪显像 室壁运动 左心室功能 

分 类 号：R541.6[医药卫生—心血管疾病]