定量组织速度成像在肥厚型梗阻性心肌病化学消融术前后的应用  

Application of quantitative tissue velocity imaging in percutaneous transluminal septal myocardial ablation of hypertrophic obstructive cardiomyopathy

作　　者：唐海林[1] 赵博文[1] 傅国胜[2] 杨倩[1] 方凡[1] 何跟山[1] 徐海珊[1] 潘美[1] 汤富刚[1] 

机构地区：[1]浙江大学医学院附属邵逸夫医院超声科 浙江大学邵逸夫临床医学研究所,杭州310016 [2]浙江大学医学院附属邵逸夫医院心内科 浙江大学邵逸夫临床医学研究所,杭州310016

出　　处：《中华超声影像学杂志》2007年第10期829-831,共3页Chinese Journal of Ultrasonography

摘　　要：目的应用定量组织速度成像（QTVI）评价肥厚型梗阻性心肌病化学消融术前及术后左心室局部收缩功能,并探讨前间隔基底段（靶组织）收缩速度与左室流出道压差关系。方法23例肥厚型梗阻性心肌病患者于化学消融术前及术后3d,超声心动图测量左室流出道压差;应用QTVI技术在心尖左室长轴观及心尖四腔观测量前间隔、后壁、后间隔和侧壁基底段与中间段的纵向收缩期峰值速度（Vp）,在胸骨旁左心室长轴观测量前间隔及后壁基底段与中间段的横向Vp。结果肥厚型梗阻性心肌病患者前间隔基底段的纵向及横向Vp术后[分别为（3.25±0.63）cm/s、（2.93±0.47）cm/s]较术前[分别为（5.73±0.96）cm/s、（4.87±0.69）cm/s]减低（P〈0.05）。肥厚型梗阻性心肌病患者左室流出道压差术后[（23.7±7.8）mmHg]较术前[（78.3±16.5）mmHg]下降（P〈0.01）,左室流出道压差下降与前间隔基底段Vp下降显著相关（r=0.95,P〈0.01）。结论肥厚型梗阻性心肌病化学消融术后前间隔基底段收缩功能下降,左室流出道压差下降与前间隔基底段收缩功能下降有关。　Objective By quantitative tissue velocity imaging（QTVI）,to evaluate regional left ventricular（LV） contractile function before and after percutaneous transluminal septal myocardial ablation （PTSMA） in patients with hypertrophic obstructive cardiomyopathy （HOCM）,and to investigate correlation between the peak systolic velocity（Vp） at the base segments of anterior interventricular septum with LV outflow-trace gradient（LVOTG）.Methods Before and 3 days after PTSMA in 23 patients with HOCM,LVOTG were measured,Vp at the base and middle segments of anteroseptal,posterior,posterseptal and lateral along LV apical long-axis view and apical four-chamber view were measured by QTVI,Vp at the base and middle segments of anteroseptal,posterior along LV parasternal the long-axis view were measured by QTVI.Results Three days after PTSMA,Vp at the base segments of anteroseptal decreased significantly from （5.73±0.96）cm/s to （3.25±0.63）cm/s along LV apical long-axis view,from （4.87±0.69）cm/s to （2.93±0.47）cm/s along LV parasternal the long-axis view （P〈0.05）.LVOTG reduced significantly from （78.3±16.5）mm Hg to （23.7±7.8）mm Hg（P〈0.01）.LVOTG correlated positively to Vp at the base segments of anteroseptal （r=0.95,P〈0.01）.Conclusions After PTSMA in patients with HOCM,Vp at the base segments of anteroseptal significantly decreased and LVOTG significantly reduced,LVOTG had a good linear correlation to Vp at the base segments of anteroseptal.

关 键 词：超声心动描记术 心肌病 肥厚性 导管消融术 组织速度成像 

分 类 号：R686[医药卫生—骨科学]