速度向量成像对右室起源室性期前收缩左心室收缩期旋转运动的研究  

Study of left ventricular twisting in premature ventricular contraction from right ventricle by velocity vector imaging

作　　者：姚静[1] 许迪[1] 陆凤翔[1] 雍永宏[1] 季玲[1] 曹克将[1] 

机构地区：[1]南京医科大学第一附属医院心脏科,210029

出　　处：《中华超声影像学杂志》2008年第6期479-483,共5页Chinese Journal of Ultrasonography

基　　金：基金项目：国家自然科学基金（30772060）

摘　　要：目的应用速度向量成像（velocity vector imaging，VVI）技术分析正常人及右室起源室性期前收缩（premature ventricular contraction，PVC）二联律患者不同层面心肌旋转参数，探讨窦性心律及右室起源PVC时左室心肌力学变化规律。方法应用VVI技术对10例右室起源PVC二联律患者窦性、室性心搏及12例健康志愿者胸骨旁左心室短轴观二尖瓣、心尖水平的心肌旋转角度及解旋启动时间进行定量分析。结果正常人左室二尖瓣水平呈顺时针旋转，心尖水平呈逆时针旋转，内膜旋转角度大于外膜（P〈0．01）；右室起源PVC二联律患者窦性心搏时各水平心肌旋转角度较正常组降低（P〈0．05），解旋启动时间前移（P〈0．05）；右室PVC二联律患者室性心搏时旋转曲线呈双向，收缩早期与正常组及PVC窦性心搏呈反向旋转。结论心肌旋转参数可用于评价不同激动时序时心肌运动力学状态，VVI技术可为该研究提供方法学基础。Objective To assess left ventricular（LV） twisting parameters in different layers with velocity vector imaging（VVI） in both healthy subjects and premature ventricular contraction（PVC） bigeminy from right ventricle（RV） patients,and investigate the rules of LV myocardium dynamics in sinus rhythm and PVC from RV. Methods Ten patients with PVC bigeminy from RV and twelve healthy subjects underwent the examination of two-dimensional ultrasound, in which the standard LV mitral valve （MV） and apical short-axis views were acquired. The twisting angle（TA） and untwisting starting time（UST） were measured. Results In healthy subjects myocardium of LV MV short-axis twisted in clockwise, while the myocardium of LV apical short-axis twisted in counter-clockwise. TA of endocardium was higher than that of epicardium（ P〈0.01）. In PVC bigeminy from RA patients,their TA during sinus contraction was lower than that of healthy subjects both in MV and apical shortaxis respectively（ P〈0.05）,and UST was earlier（ P〈0.05）. In PVC the TA curve is bidirectional,and in early systolic TA twisted reversely compared with that of healthy subjects and sinus contraction in PVC patients. Conclusions Twisting parameters could be used to assess myocardium dynamics during different ventricular mechanical activation. VVI was a novel tool to analyze myocardium twisting.

关 键 词：超声心动图描记术 室性早搏复合征 心室功能 左 速度向量成像 

分 类 号：R686[医药卫生—骨科学]