速度向量成像技术评价肥厚型心肌病左心室扭转功能  

Assessment of left ventricle twist in hypertrophic cardiomyopathy using velocity vector imaging

作　　者：刘晓伟[1] 李治安[1] 杨娅[1] 

机构地区：[1]首都医科大学附属北京安贞医院超声医学科,100020

出　　处：《中华医学超声杂志（电子版）》2010年第3期28-31,共4页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：高等学校博士学科点专项科研基金(20060025001)

摘　　要：目的应用超声心动图速度向量成像技术对肥厚型心肌病患者心脏扭转运动进行初步分析,探讨肥厚型心肌病患者在左心室射血分数(LVEF)正常时心脏局部和整体扭转功能是否有改变。方法肥厚型心肌病患者和健康体检者各30名。常规测量有关左心功能参数:LVEF、舒张末期容积(EDV)、收缩末期容积(ESV)、每搏量(SV)、二尖瓣口E、A峰值血流速度等。速度向量成像模式下在系列胸骨旁短轴观图像上测量收缩期心内膜下和心外膜下心肌的最大旋转角度、峰值旋转速率、圆周应变(CS)、圆周应变率(CSR)、舒张期和等容舒张期峰值解旋转速率。结果肥厚型心肌病组EDV、ESV、SV明显减低,A峰增高(P<0.01);心内膜下心肌左心室扭转角度和扭矩增高,解扭转率减低(P<0.05);心外膜下心肌的基底部峰值旋转速率、峰值解旋转速率减低(P<0.05);心外膜下心肌的CS、CSR明显减低(P<0.05)。结论肥厚型心肌病患者心脏整体扭转角度和速度较正常人增高,局部心肌圆周方向形变能力下降,以心外膜下心肌下降更为明显。Objective To assess cardiac twist in the patients with hypertrophic cardiomyopathy （HCM） using echoeardiography velocity vector imaging （VVI） technique. Methods Thirty patients with hypertrophic eardiomyopathy and 30 healthy volunteers were enrolled in this study. The standard left eehocar- diographie ventricle images （the parasternal basal, papillary muscle and apical level short axis view, apical 4-chamber, 2-chamber view） were obtained respectively. LV ejection fraction （LVEF） , LV end-diastolic volume（ EDV）, LV end-systolic volume（ ESV）, stroke volume（ SV）, mitral valve orifice peak early diastolic flow velocity （ E）, peak diastolic flow velocity with atrial contraction （A） were measured. The systolic maxi- mal rotation degree, peak rotation rate, circumferential strain（CS） and strain rate（ CSR）, end-diastolic and end-isovolumie relaxation period peak un-rotation rate of subendoeardial and subepieardial myocardium were analyzed by VVI offline software. Results （1） Quantitative analysis showed EDV, ESV and SV were sig- nificantly decreased, while peak A was increased in HCM group（ P 〈 0.01 ）. （2） Left ventricular subendocardial twist and torsion were increased in HCM group, whereas untwist rate was significantly decreased （ P 〈 0.05 ）. （3） The basal peak rotation rate and peak un-rotation rate were decreased （ P 〈 0.05 ）. （4） In addition, CS and CSR of subepieardial myocardium in HCM group were lower than those of control group（ P 〈 0.05）. Conclusion Cardiac twist angle and velocity of HCM patients are higher than those of the healthy person, but the circumferential deformation ability of the regional myocardium is impaired, especially for the subepicardial myoeardium.

关 键 词：超声心动描记术 扭转 肥大性心肌病 

分 类 号：R542.2[医药卫生—心血管疾病]