超声二维应变成像评价肥厚型心肌病患者左心室收缩功能  

Evaluation of left ventricular systolic function in patients with hypertrophic cardiomyopathy by two-dimensional strain echocardiography

作　　者：余芬[1] 邓又斌[1] 申屠伟慧[1] 熊莉[1] 张芸[1] 杨好意[1] 黄润青[1] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030

出　　处：《中华超声影像学杂志》2007年第9期742-745,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用超声二维应变成像评价肥厚型心肌病（HCM）患者左室局部心肌收缩功能。方法HCM患者21例，正常对照者21例，获取左室短轴观二尖瓣环水平、乳头肌水平、心尖水平，心尖位四腔观、二腔观及左室长轴观的二维图像，测定左室心尖位二维纵向应变收缩期峰值，左室短轴二尖瓣水平、乳头肌水平、心尖水平各心肌节段心内膜下、心外膜下及整体心肌径向收缩期峰值应变。结果①HCM组与正常组心尖位二维纵向收缩期峰值应变比较，HCM组绝大多数节段心肌峰值应变显著降低（P〈0．05）；②HCM组与正常组左室短轴心内膜下心肌二维径向收缩期峰值应变比较，HCM组心肌收缩期峰值应变明显减低，二尖瓣水平及乳头肌水平绝大多数节段差异有统计学意义（P〈0．05）；③HCM组与正常组左室短轴心外膜下心肌二维径向收缩期峰值应变比较，绝大多数节段差异无统计学意义；④HCM组与正常组左室短轴心肌整体二维径向收缩期峰值应变比较，HCM组绝大多数节段心肌峰值应变显著降低（P〈0.05），尤以肥厚节段较多的乳头肌水平明显（P〈0．01）。结论HCM患者肥厚与非肥厚节段于左室纵向及左室短轴径向收缩功能均受损，并且径向收缩功能受损以心内膜下心肌为主。Objective To evaluate regional myocardial systolic function in patients with hypertrophic cardiomyopathy（HCM） by two-dimensional strain echocardiography. Methods Twenty-one patients with HCM and twenty one healthy volunteers were included. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscle and apex, and the apical four-chamber view, two-chamber view and long-axis of the left ventricle. The peak systolic longitudinal strain was measured in the apical views. The peak systolic radial strain of the subendocardium, the subepicardium and the whole wall were measured in the left ventricular short-axis views using two- dimensional strain software. Results The peak systolic longitudinal strain of different segments in patients with HCM was significantly reduced when compared with the control group（ P %0.05）. The peak systolic radial strain of the subendocardium of different segments in patients with HCM was lower than those of control group. The peak systolic radial strain of the subepicardium of different segments in patients with HCM had no statistical difference between the control group. The peak systolic radial strain of different segments in patients with HCM were significantly decreased as compared with the control group （ P〈0.05）. Conclusions The systolic longitudinal strain and the systolic radial strain of left ventricular regional myocardium were impaired in patients with HCM,especially in the subendocardium.

关 键 词：超声心动描记术 心肌病 肥厚性 心室功能 左 二维应变 

分 类 号：R686[医药卫生—骨科学]