应用组织追踪成像评价儿童扩张型心肌病左心功能的探讨  

Evaluation of left ventricular function in children with dilated cardiomyopathy using tissue tracking imaging

作　　者：熊复[1] 余更生[1] 白永虹[1] 计晓娟[1] 田杰[1] 钱永如[1] 

机构地区：[1]重庆医科大学附属儿童医院心内科,重庆400014

出　　处：《临床心血管病杂志》2008年第6期462-465,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨组织追踪技术(TTI)在儿童扩张型心肌病(DCM)左心收缩功能评价中的应用价值。方法:DCM患者14例,NYHA分级分为DCM A组(HYHAⅡ级)和DCM B组(HYHAⅢ-Ⅳ级),健康儿童12例为对照组。用GE Vivid 7彩色多普勒超声显像仪同步获取心尖四腔、左室两腔和左室长轴切面的三平面TTI动态图,分析左室TTI图及心肌收缩期向心尖方向的位移距离(Ds)。结果:①DCM组收缩期TTI图色阶较对照组减少。②DCM组左室各节段Ds较对照组显著降低,以DCM B组降低更显著(P<0.05);DCM B组部分病例Ds呈中间段>基底段>瓣环、部分室壁二尖瓣瓣环平均Ds小于基底段及中间段。③DCM组有4例18个心肌节段(25.00%)出现纵向收缩延迟,均来自DCM B组。④对照组、DCM A组及B组二尖瓣瓣环Ds与左室射血分数相关性好(r=0.74、0.80、0.82,P<0.01)。结论:TTI技术能快速、直观、无创评价局部及整体左心收缩功能,对儿童DCM患者同样适用。Objective：This study was designed to assess the left ventricular （LV） systolic function in Children with dilated cardiomyopathy （DCM） using tissue tracking imaging （TTI）. Method： Fourteen consecutive children with DCM were included in the present study, who were divided into group A （with light cardiac dysfunction） and group B （with severer cardiac dysfunction） according to NYHA class. Twelve children without any cardiac diseases were controls. The dynamic tri-plane TTI images of apical four-chamber, LV two-chamber and LV long-axis views were acquired simultaneously using Vivid Seven Ultrasound Imaging System with tissue tracking technology. The TTI images of LV and systolic displacements （Ds） of cardiac tissue toward apex of the heart in the longaxis direction were analyzed. Result：①Compared with the controls, the colors decreased seriously in group A and B, especially in group B. ②The Ds reduced in DCM group compared with that of controls, especially in group B （P〈0.05）. The Ds increased from base to apex of the heart in some cases of group B and the mean Ds of mitral annulus were even less than that of the base and middle segments in some walls of group B. ③ There were eighteen segments （25.00%） with delayed longitudinal contraction in four cases from group B. ④There was a good correlation between the mean Ds from six sites of the mitral annulus and LVEF in controls, group A and B （r=0.74, 0.80, 0. 82 ,P〈0. 0001）. Conclusion： TTI is a new, rapid and noninvasive method to assess LV systolic function and also can be used in Children with dilated cardiomyopathy.

关 键 词：组织追踪法 扩张型心肌病 左心功能 儿童 

分 类 号：R725.4[医药卫生—儿科] R543.1[医药卫生—临床医学]