斑点追踪显像对慢性心力衰竭患者心脏再同步化治疗短期疗效的评价  

Assessment of short-term effect of cardiac resynchronization therapy by speckle tracking strain imaging

作　　者：李雪[1] 张军[1] 刘丽文[1] 朱霆[1] 刘兵[2] 李金芳[1] 

机构地区：[1]第四军医大学西京医院超声科,西安710033 [2]第四军医大学西京医院心内科,西安710033

出　　处：《中华超声影像学杂志》2009年第9期737-740,共4页Chinese Journal of Ultrasonography

摘　　要：目的探讨超声斑点追踪显像（STI）技术对慢性心力衰竭患者心脏再同步化治疗（CRT）短期疗效的评价价值。方法16例慢性心力衰竭患者，获取心尖长轴观测量各节段收缩期纵向应变达峰时间、径向应变达峰时间，胸骨旁短轴观测环向应变达峰时间，计算CRT术后1个月、术后3个月18节段纵向、径向、环向应变达峰时间标准差（LS-SD18、RS-SD18、CSSD18），左室各节段收缩期纵向、径向、环向应变达峰时间最大差值（LS-dif、RS-dif、Cs-sif）作为应变非同步指标。将术后3个月、1个月18节段纵向、径向、环向应变达峰时间标准差与术前的差值（△LS-SDl8、AR-SD18、ACS-SD18）与术后3个月、1个月左室收缩末容积减少百分比（△EsV％）进行相关性分析。结果CRT后1个月、术后3个月LS-SD18、RS-SDl8、CSSD18及RS-dif较术前显著减少，差异有统计学意义（P〈0．05）；术后3个月ARS-SD18与术后3个月AESV％具有明显的相关性（r=0．694）。结论应变非同步指标对评价短期CRT后机械非同步性具有重要意义。Objective To assess the short term effect of cardiac resynchronization therapy （CRT） by speckle tracking strain irnaging（STI）. Methods Sixteen chronic heart failure patients（CHF） with CRT were enrolled. The time to peak systolic longitudinal strain and the time to peak systolic radial strain were derived from the LV apical views, and the time to peak systolic circumferential strain was derived from the parasternal short axis. The standard deviation for time to peak longitudinal, radiaI and circumferential strain in the 18 segments （LS- SD1 8, RS-SD1 8, CS-SD1 8） and the maximal temporal difference of any two segments （ LS-dif, RS-dif, CS-dif） were calculated as a strain-derived dyssynchrony index. The difference of LS-SD18, RS-SD18, CS-SD18 between 1 month,3 months after CRT and baseline （ALS SD18, ARS-SD18, ACS-SD18） was calculated. The correlation between ALS-SD18, ARS-SDI8,ACS SD18 and the reduction of end systolic volume at follow-up（AESV~/00 ） were analyzed. Results The LS-SD18, RS-SD18,CS-SD18 and RS-dif were decreased significantly 1 month, 3 months after CRT. ARS-SD18 was correlated with AESV% 3 months after CRT（ r = 0. 694）. Conclusions The strainderived dyssynchrony index is great significient for short-term effect of CRT.

关 键 词：超声心动描记术 心力衰竭 充血性 心脏再同步化治疗 斑点追踪显像 

分 类 号：R686[医药卫生—骨科学]