二维斑点追踪成像评价急性心肌梗死后左心室收缩同步性  

Evaluation of left ventricular dyssynchrony with two-dimensional speckle tracking echocardiography in acute myocardial infarction

作　　者：马春燕[1] 李秀云[1] 任卫东[1] 刘爽[1] 赵世杰[2] 

机构地区：[1]中国医科大学附属第一医院心功能科,辽宁沈阳110001 [2]中国医科大学附属第一医院循环内科,辽宁沈阳110001

出　　处：《中国医学影像技术》2009年第10期1800-1802,共3页Chinese Journal of Medical Imaging Technology

摘　　要：目的采用超声二维斑点追踪成像(STE)评价急性心肌梗死(AMI)后左心室收缩同步性及其影响因素。方法65例QRS宽度正常的AMI患者在AMI发作72h之内及60名正常人行STE检查,检测心肌峰值纵向应变(LSpeak)代表心肌收缩功能,并测量左心室短轴水平心肌节段收缩期达峰值径向应变的时间(TRS),将前间壁和后壁TRS的差值(TAS-POST)≥130ms定义为左心室收缩不同步。以心肌室壁运动评分指数(WMSI)代表AMI面积(MIS)。结果AMI患者左心室射血分数(LVEF)和LSpeak减小,TAS-POST延长。AMI导致左心室收缩不同步的发生率为64.62%(42/65)。TAS-POST与LVEF、LSpeak和MIS(WMSI)显著相关,与QRS宽度无相关性。MIS(WMSI)是TAS-POST最有力的独立预测因素。结论QRS宽度正常的AMI患者可出现左心室收缩不同步,且MIS是收缩不同步的主要影响因素。STE能够准确评价左心室收缩同步性。Objective To evaluate the left ventricular （LV） systolic dyssynchrony after the acute myocardial infarction （AMI） with two-dimensional speckle tracking echocardiography （STE）. Methods STE were performed in 65 patients within 72 h of AMI and compared with 60 age- and sex-matched healthy volunteers. The peak longitudinal strain （LSpeak） was measured at LV myocardium. LV dyssynchrony was defined as an interval ≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall （TAS POST）. Size of myocardial infarction （MIS）was confirmed by wall-motion score index （WMSI）. Results The LSpeak and LV ejection fraction （LVEF） were lower, and WM SI and TAS-POST were larger in AMI patients compared with controls. Forty-two patients had developed LV dyssynchrony （64.62%）, and there were strong correlation between LV dyssynchrony （TAS-POST） and LSpeak, LVEF, and WMSI （MIS）. MIS was the most independent predictor for systolic dyssynchrony. Conclusion AMI with normal QRS can induce LV dyssynchrony, which is mainly determined by MIS. STE is a reliable technique for accurate evaluation of LV synchrony.

关 键 词：超声心动描记术 心肌梗死 左心室收缩同步性 心肌梗死面积 

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