斑点追踪技术描述肥厚型心肌病左室收缩不同步性及收缩后收缩现象临床价值研究  

Assessment of left ventricular dyssynchrony and post systolic shortening in hypertrophic cardiomyopathy

作　　者：张音佳[1] 陈悦[2] 黄国英[1] 

机构地区：[1]复旦大学附属儿科医院心血管中心,上海201102 [2]上海华东医院,上海200040

出　　处：《中国实用内科杂志》2010年第10期924-926,共3页Chinese Journal of Practical Internal Medicine

摘　　要：目的探讨斑点追踪技术描述肥厚型心肌病(HCM)左室局部收缩同步性情况及收缩后收缩现象(PSS)出现情况临床价值。方法选择2008年1月至12月上海华东医院HCM患者18例,年龄21～78岁。同期就诊的正常人36名为对照组,年龄19～76岁。采用GE-VIVID7超声诊断仪,选取超声心动图短轴二尖瓣水平、乳头肌水平及心尖水平切面观,运用斑点追踪技术取得不同水平不同节段的径向应变/应变率及圆周应变/应变率曲线,分别计算圆周及径向应变收缩期达峰时间,并观察PSS。结果 HCM组与对照组圆周方向和径向方向达峰时间分别为(398±28)ms对(378±57)ms(P<0.05)和(418±52)ms对(370±51)ms(P<0.001),HCM组与对照组圆周及径向应变达峰时间分别为(80±27)ms对(48±18)ms(P<0.001)和(91±19)ms对(41±14)ms(P<0.001),均较对照组延长。HCM组增厚节段和未增厚节段达峰时间以及达峰时间标准差差异无统计学意义。HCM组PSS较正常组增加,多集中在基底段和心尖段,增厚节段出现PSS较非增厚节段显著增加。结论 HCM左室收缩不同步性显著,PSS明显增加。斑点追踪技术能较好地评价HCM不同运动方向上的心肌同步性情况。Objective To evaluate regional left ventricular dyssynchrony in hypertrophic cardiomyopathy （HCM） and analysis the post systolic deformation （PSS）. Methods 36 healthy subjects （age from 19 -76 years, mean age 51 ± 13 years） and 18 patients with HCM （ age from 21 - 78 years, mean age 53 ± 14 years ） were examed. Conventional echocardiography were performed to obtain basal, middle, and apical 2D LV short-axis in 17 patients witn HCM and 34 age-matched controls,acquired different time to radial peak systolic（Trs） and to circumferential peak systolic （Tcs） , and observe the PSS. Results The Tcs in HCM groups and the controls is （398 ±28）ms vs （378 ±57）ms（P 〈0. 05） ,The Tcs in HCM groups and the controls is （418 ±52）ms vs （370 ±51） ms （P 〈 0. 001 ）. All were all prolonged in HCM, no matter in hypertrophic segment or not. Compared with the controis,the Ts-18SD were also increased in both circumferential deformation[ （80± 27）ms vs （48 ± 18）ms,P 〈 0. 001 ] and radial deformation[ （91 ± 19 ）ms vs （41 ± 14）ms, P 〈 0. 001 ]. In H CM, the PSS are inereased than the controls, especially in the basal and apical. The hypertrophic segments have more PSS than non-hypertrophic segments in patient with HCM. Conclusion Speckle tracking imaging gives a new methods to assess the dyssynchrony and PSS in HCM.

关 键 词：超声心动描计术 心肌疾病 肥厚型 心室功能 收缩后收缩 

分 类 号：R5[医药卫生—内科学]