二维斑点追踪评价充血性心力衰竭患者左心室扭转与收缩同步性的关系  

Evaluating the Relationship between Left Ventricular Twist and Systolic Synchrony in Patients with Congestive Heart Failure using Two-dimensional Speckle Tracking Echocardiography

作　　者：马春燕[1] 刘爽[1] 程艳彬[1] 于波[2] 张立敏[1] 杨军[1] 

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

出　　处：《中国医科大学学报》2010年第7期555-557,共3页Journal of China Medical University

基　　金：辽宁省教育厅高校科研究基金资助项目(2008748);辽宁省自然科学基金资助项目(20082106)

摘　　要：目的采用超声二维斑点追踪(STE)检测左心室扭转参数,并探讨其与左心室收缩同步性的关系。方法 STE测量48例QRS时限>120ms的充血性心力衰竭(CHF)患者和40例正常人左心室基底和心尖峰值旋转角度(Rot-Ba和Rot-Ap)及达峰时间(T-Ba和T-Ap)、基底和心尖达峰时间差(Ba-Aprotdelay)、左心室峰值扭转角度(Ptw)和达峰时间(TPtw)、主动脉瓣关闭时扭转角度(AVCtw)以及达Ptw和AVCtw的时间差(AVC-Ptwistdelay),同时测量左心室径向和纵向收缩同步性(TR-AS-POST和TL-SD)。两组进行比较。结果 CHF患者左心室Rot-Ba、Rot-Ap、Ptw和AVCtw均减低,Ba-Aprotdelay和AVC-Ptwistdelay均延长。相关分析显示Ptw和AVCtw与左室射血分数和TR-AS-POST显著相关,且Ba-Aprotdelay是Ptw的独立影响因素。结论宽QRS的CHF患者左心室扭转角度减低,且与径向同步性密切相关。STE能够准确评价左心室纵向、径向和扭转运动同步性。Objective To assess the parameters of left ventricular twist using two-dimensional speckle tracking echocardiography（STE）,and to evaluate the relationship between left ventricular twist and systolic synchrony.Methods In this study,48 patients with congestive heart failure（CHF）in whom QRS duration was longer than 120 ms and 40 normal controls were enrolled.The left ventricular apical and basal rotations,peak twist,twist at aortic valve closure（AVC）,apical-basal rotation delay,and AVC-peak twist delay were measured by STE.The left ventricular radial and longitudinal synchrony was assessed simultaneously.Results Compared with normal controls,the left ventricular apical and basal rotations,peak twist,and twist at AVC were significantly lower and the apical-basal rotation delay and AVC-peak twist delay were significantly longer in CHF patients.In CHF patients,peak twist and twist at AVC were correlated strongly with radial synchrony.Conclusion The left ventricular twist parameters decrease and are correlated with radial synchrony in CHF patients with wide QRS.STE is a reliable technique for evaluating left ventricular radial,longitudinal,and rotational synchrony.

关 键 词：二维斑点追踪 心力衰竭 左心室扭转 收缩同步性 

分 类 号：R541.6[医药卫生—心血管疾病]