实时三维超声心动图和组织多普勒显像评价左心室收缩同步性的相关性研究  

Comparison of real-time three-dimensional echocardiography and tissue Doppler imaging in assessing left ventricular systolic synchrony

作　　者：舒先红[1] 曾欣[1] 潘翠珍[1] 崔洁[1] 董丽莉[1] 陈灏珠[1] 

机构地区：[1]复旦大学附属中山医院超声心动图室上海市心血管病研究所,上海200032

出　　处：《中华超声影像学杂志》2007年第8期655-658,共4页Chinese Journal of Ultrasonography

基　　金：国家自然科学基金资助项目（30671999）

摘　　要：目的：比较实时三维超声心动图和组织多普勒显像在分析正常人和扩张型心肌病患者左心室收缩同步性中的临床价值。方法：60例研究对象分为二组：A组为31例健康志愿者，B组为29例扩张性心肌病患者。均行实时三维经胸超声心动图和组织多普勒检查，得到左室舒张末期容积、收缩末期容积、左室射血分数、心电图Q波起始点距离16节段和12节段容积最小容积点时间间隔的标准差及其最大差（分别为Tmsv16-SD，Tmsv12-SD；Tmsv16-Dif，Tmsv-2Dif）。对组织多普勒显像进行定量评价，得到心电图Q波起始点到等容收缩波峰值、收缩波峰值、舒张早期及晚期波峰值、最大应变的标准差（分别为Tmvc-SD，TS-SD，Te-SD，Ta-SD，TE-SD）。结果：B组的LVEF显著小于A组（P〈0．05）。B组的同步性参数值均大于A组（P〈0．01或P〈0．001）。TIVC-SD，TE-SD与Tmsv-16-SD,Tmsv12-SD，Tmsv16-Dif,Tmsv12-Dif显著相关（r=0．583～0．743，均P〈0．001），Ts-SD，Te-SD与Tmsv16SD和Tmsv16-Dif中等相关（r=0．561～0．605，均P〈0．001），Ts-SD，Te-SD与Tmsv12-SD和Tmsv12-Dif的相关性较弱（r=0．410～0．588，均P〈0．05），Ta-SD与实时三维超声的各参数均不相关（r=0．264～0．383，均P〉0．05）。结论：实时三维超声心动图和组织多普勒均能够评价左室心肌收缩同步性，两种方法的评价结果具有一定的相关性。Objective To investigate the correlation of systolic dyssynchrony between real-time three dimensional echocardiography（RT 3DE） and tissue Doppler imaging（TDI）. Methods Thirty-one healthy subjects and 29 patients with dilated cardiomyopathy （DCM） were enrolled and underwent RT-3DE and TDI in this study. Full volume RT-3DE and TDI were performed and analyzed using Philips iE33 echocardiographic imaging system and Qlab 4.2 software. The systolic dyssynchrony parameters derived from RT-3DE were the dispersion of time to minimum regional volume for 16 and 12 left ventricular segments （Tmsv 16-SD and Tmsv 12-SD）, and the maximum difference of time to minimum regional volume for 16 and 12 left ventricular segments （Tmsv 16-Dif, Tmsv 12-Dif）. TDI dyssynchrony indexes included the standard deviation of time to peak isometric contraction （TIVC-SD）, peak systolic velocity（Ts-SD）, peak early and late diastolic velocities （Te-SD, Ta SD）, and peak strain （TE SD）. Results All the systolic dyssynchrony parameters derived from RT 3DE and TDI were significantly larger in the DCM group than those of the control group（ P 〈0.01～0. 001）. For TIVC-SD and TE-SD,a significant correlation with Tmsv 16- SD,Tmsv12 SD,Tmsv16 Dif,Tmsvl2 Dif （ r = 0. 583～0. 743 ,all P 〈0. 001） was found. There was a moderate correlation between Ts-SD,Te-SD and Tmsv 16 SD,Tmsv 16 Dif （ r= 0. 561～0.605,all P〈0. 001）. There was a weak correlation between Ts-SD, Te-SD and Tmsv 12-SD, Tmsv 12 Dif （ r = 0. 410 ～ 0. 588, all P 〈0.05）. There was no correlation between Ta-SD and RT-3DE parameters. Conclusions RT-3DE and TDI provide effective tools to assess the left ventricular systolic synchronicity. There are various degree of correlations between some synchrony parameters of RT-3DE and TDI.

关 键 词：超声心动描记术 实时三维 心室功能 左 心肌病 扩张型 组织多普勒显像 

分 类 号：R686[医药卫生—骨科学]