应变率成像评价心肌梗死患者左心室局部舒张功能研究  

Evaluation of regional left ventricular diastolic function in patients with myocardial infarction by straining rate imaging

作　　者：王世宏[1] 

机构地区：[1]北京军区总医院心内科,北京市100700

出　　处：《河北医药》2009年第20期2707-2709,共3页Hebei Medical Journal

摘　　要：目的探索冠状动脉硬化性心脏病(冠心病)患者左心室舒张各期局部心肌应变率特点及其评价左心室局部舒张功能的可能性。方法对56例前壁心肌梗死患者(MI组)和78例正常对照者(NOR组)左心室心肌进行组织多普勒成像检查。记录心尖二腔动态图像,应用应变率成像描记技术获取左心室各阶段心肌同步应变率曲线,测量等容舒张期(IR期)、快速充盈期(RF期)、缓慢充盈期(SF期)、心房收缩期(AC期)局部心肌应变率变化幅度,对2组结果进行对比分析。结果在整个舒张期,正常对照组SR多在基线水平或为正值;MI组正常规律消失,梗死区域多为负值。IR期正常人应变率多在基线附近,应变率绝对值较小,MI组患者各节段心肌应变率相差较大。RF期,正常对照组应变率多为正值,MI组SR丧失正常时的梯度变化规律。在SF期,NOR组应变率多数接近0;而在MI组,应变率多数为正值。在心房收缩期,NOR和MI组应变率均为正值,MI组梗死区应变率值为负值。结论局部心肌缺血梗死导致整个舒张期的局部心肌应变率显著异常。应变率成像能敏感、直观、无创地定量评价局部心肌细胞活力和舒张功能。Objective To investigate the straining rate features of regional wall abnormalities in patients with coronary artery disease during diastolic period, and its possibility to evaluate regional left ventricular diastolic function. Methods 56 patients with anterior myocardial infarction （MI group） and 78 normal subjects （NOR group） underwent Doppler tissue imaging, which were performed in 2 -chamber-view by straining rate imaging synchronously. Results In NOR group, most of SR values were near the base line or positive value. But the normal rules disappeared and SR of the infarction area was negative in MI group. IR phase ： most of segments were near the base line, but in MI group, SR was quite different. RF phase ： in NOR group, there were high upward waves. SF period：compared with that in NOR group, which was horizontal, and MI group had upward bands. In AC period, SR of the infarction area was negative in MI group. Conclusion Regional myocardial ischemia and infarction can cause significant regional diastolic wall abnormalities of straining rate value at active diastolic phase. Regional diastolic wall motion abnormalities can be evaluated quantitatively and synchronously with high sensitivity by SRC which has the potential value in evaluating eardiocyte viability and diastolic function.

关 键 词：应变率成像 心肌梗死 心肌细胞活力 舒张功能 局部心室 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541.4[医药卫生—诊断学]