心尖部心肌梗死左室扭转变化的超声研究  

Changes of Left Ventricular Torsion in Apical Infarction on Ultrasound

作　　者：郭宝生[1] 任卫东[1] 唐力[1] 陈昕[1] 张立敏[1] 李楠[1] 富维强[1] 

机构地区：[1]中国医科大学附属第一医院心血管检查科,沈阳市110001

出　　处：《中国超声医学杂志》2008年第11期989-991,共3页Chinese Journal of Ultrasound in Medicine

摘　　要：目的研究心尖部心肌梗死时左室扭转的变化规律。方法32例心尖部心肌梗死患者为研究对象,15例健康志愿者为对照组。用组织多普勒测量左室侧壁及室间隔旋转速度并对其进行时间积分来计算左室旋转,根据前、后壁沿声束方向的运动速度计算左室短轴切面心腔半径的变化以准确计算左室扭转。左室扭转为心尖与心底旋转的差值,大小用度表示。用左室短轴切面侧壁和室间隔二者圆周应变率的平均值反映不同切面左室心肌收缩性。比较心尖梗死者与对照组间左室扭转、旋转及应变率的变化。根据检测结果分析心尖在左室扭转中的作用及左室旋转与心肌收缩性的关系。结果心尖部心肌梗死患者的左室扭转较对照组显著降低(6.9°±4.1°及11.4°±5.3°,P<0.002),其主要原因为前者的心尖旋转较后者显著减低(5.6°±2.7°及9.6°±4.5°,P<0.002)。心尖梗死患者心尖旋转幅度的减低与心尖梗死区心肌应变率减低密切相关(r=0.74)。结论心尖梗死引起左室扭转明显减低,主要是由于心尖旋转的显著减低;心尖在左室扭转中起重要作用;心尖旋转与心尖部心肌收缩功能密切相关。Objective To detect the regularity of left ventricular torsion （LVT） in apical infarction.Methods Thirty-two patients with apical infarction were the subjects,and fifteen healthy volunteers were the contrasts.Using tissue Doppler imaging,LVT was calculated with the integrated rotating speeds of the left lateral wall and interventricular septum. For accurately calculating LVT,the radius changes of left ventricular chamber at left ventricular short-axis plane was calculated by the integrated moving speeds of anterior and posterior walls. LVT was the difference between apical and basal rotations,of which the values were analyzed with the motion amplitude. The contractility of left ventricular myocardium was reflected by averaged circumferential strain rate imaging （SRI） of left lateral wall and interventricular septum at left ventricular short-axis plane. LVT,left ventricular rotation and SRI of apical infarction were compared with those of the contrasts. Based on the results of the study,we analyzed the role of apex playing in LVT and the relationship between left ventricular rotation and myocardial contractility.Results Compared with the contrasts,LVT in apical infarction was significantly decreased （6.9°±4.1° vs 11.4°±5.3°,P〈0.002） mainly due to the significant decrease of apical rotation（AR） （5.6°±2.7° vs 9.6°±4.5°,P〈0.002）. There was a close relationship between the decrease of AR in the patients with apical infarction and the decrease of SRI in apical infarction （r=0.74）.Conclusions The significant decrease of LVT in apical infarction mainly owing to the significant decrease of AR;apex plays a key role in LVT; there was a close relationship between AR and apical myocardial contractility.

关 键 词：心尖部心肌梗死 左室扭转 组织多普勒 应变率 

分 类 号：R542.22[医药卫生—心血管疾病] R445.1[医药卫生—内科学]