二维应变评价扩张型心肌病心室内不同步对功能性二尖瓣反流的影响  

Two-dimensional Strain Evaluaing Affects of Intraventricular Dyssynchrony in Dilated Cardiomyopathy on Functional Mitral Regurgitation

作　　者：何亚乐[1] 费洪文[1] 侯跃双[1] 林纯莹[1] 许燕[1] 

机构地区：[1]广东省人民医院暨广东省心血管研究所心内科,广州市510100

出　　处：《中国超声医学杂志》2008年第9期802-805,共4页Chinese Journal of Ultrasound in Medicine

基　　金：广东省科技计划(No.2005B30601006);广东省自然科学基金博士启动项目(No.05300738)

摘　　要：目的二维应变超声评价扩张型心肌病心室内不同步与功能性二尖瓣反流的关系。方法扩张型心肌病41例,分为两组,重度二尖瓣反流组(A组)26例,非重度二尖瓣反流组(B组)15例。左室乳头肌短轴切面测量前外、后内组乳头肌处心肌二维应变(轴向及环向)峰值及达峰时间差值。结果前外、后内组乳头肌处心肌二维应变达峰时间差值A组大于B组(P<0.05);二维应变峰值两组无明显差异(P>0.05);多元回归分析表明二维应变达峰时间差值与二尖瓣反流密切相关(P<0.01)。结论扩张型心肌病前外、后内组乳头肌处心肌运动不同步影响二尖瓣同步关闭,是功能性二尖瓣反流原因之一,二维应变超声能够评价这种不同步现象。Objective To apply two-dimensional strain to evaluate the affects of intraventricular dyssynchrony in dilated cardiomyopathy （DCM） on functional mitral regurgitation （MR）. Methods Fourty-one DCM patients were divided into two groups： group A （26 patients） with severe MR and group B （15 patients） without severe MR. Two- dimensional strain echocardiography was performed to assess the radial and circumferantial peak strainand time difference between 2 segments adjacent to the anterolateral and posteromedial papillary muscles from a short axis view. Results The peak strain time difference was significantly increased in group A compared to group B （P〈 0.05）, while no difference of peak strain were found between the two groups （P〈0.05） .Stepwise multiple regression analysis showed that peak strain time difference was closed related to functional mitral regurgitation （MR） （P（0.01） . Conclusions Dyssynchrony of myocardial segments adjacent to the papillary muscles may disturb synchronized closure of the mitral leaflets and cause MR in DCM. Two-dimensional strain may be used to evaluate this kind of intraventricular dyssynchrony.

关 键 词：二维应变 扩张型心肌病 心室内不同步 功能性二尖瓣反流 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]