组织运动二尖瓣环位移自动追踪技术对急性心肌梗死患者左心室整体收缩功能的评价  

Preliminary clinical study of left ventricular global systolic function in patients with acute myocardial infarction by automated motion tracking of mitral annular displacement

作　　者：段凤霞[1] 袁莉[1] 谢明星[1] 王新房[1] 吕清[1] 方凌云[1] 

机构地区：[1]华中科技大学协和医院超声科湖北省分子影像重点实验室,武汉430022

出　　处：《临床心血管病杂志》2011年第12期905-908,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨组织运动二尖瓣环位移自动追踪技术(TMAD)在评价急性心肌梗死(AMI)患者左心室整体收缩功能中的临床应用价值。方法:选取AMI患者29例为AMI组,年龄匹配的健康志愿者31例为对照组,采用Philips IE33彩色超声诊断仪,行常规超声心动图检查,应用双平面Simpson法测量左心室舒张末容积、左心室收缩末容积和左心室射血分数(LVEF)。存储心尖四腔、三腔和两腔连续3～5个心动周期二维动态图像,用Qlab 7.0软件进行脱机分析,测量二尖瓣环6个位点收缩期最大位移(Ds)、瓣环连线中点最大位移(D-mid)和左心室长轴缩短率(FSL),分别计算其均值,并与简化双平面Simpson测量的LVEF做相关分析。结果:①与对照组相比,AMI组二尖瓣环6个位点Ds、D-mid、FSL及其均值显著降低,均差异有统计学意义(均P<0.001);②2组Ds均值、D-mid均值及FSL均值与LVEF均具有相关性(AMI组r分别为0.787、0.776和0.779,P<0.001;对照组r分别为0.662、0.706和0.759,P<0.001);③重复性检验:AMI组Ds均值、D-mid均值及FSL均值观察者内变异系数分别为4.67%、4.60%和4.31%,观察者间变异系数分别为6.09%、5.60%和5.65%;对照组上述指标观察者内变异系数分别为5.28%、4.83%和4.93%,观察者间变异系数分别为5.57%、5.42%和4.91%。结论:TMAD技术可作为一种简单、准确及客观评价AMI患者左心室整体收缩功能的新方法。Objective：To assess the left ventricular global systolic function in patients with acute myocardial infarction（AMI） by automated motion tracking of mitral annular displacement（TMAD）.Method：Twenty nine patients with AMI and 31 age-matched normal controls were enrolled in this study.After routine echocardiography by Philips IE33,left ventricular end-diastolic volume（LVEDV）,left ventricular end-systolic volume（LVESV） and left ventricular ejection fraction（LVEF） were measured by biplane Simpson＇s method.Apical four-chamber,three-chamber and two-chamber two-dimensional dynamic images were stored,which lasted three to five consecutive cardiac cycles.The parameters were obtained using offline Qlab 7.0 software： maximal systolic displacement（Ds） of every annulus,systolic displacement of the middle point（D-mid）,long-axis fractional shortening（FSL）,then the mean of Ds,D-mid and FSL were calculated respectively.The correlation between mitral annular motion parameters and LVEF were analyzed. Result：①Ds,D-mid,FSL and the mean of Ds,D-mid and FSL were significantly decreased in AMI group compared with normal controls（P0.001 for all）.②There was correlation between the mean of Ds,the mean of D-mid,the mean of FSL and LVEF in both groups（AMI group： r=0.787,0.776,0.779,P0.001;control group： r=0.662,0.706,0.759,P0.001）;③Intraobserver variabilities of the mean of Ds,D-mid,and FSL were 4.67%,4.60%,4.31% and interobserver variabilities of the mean of Ds,D-mid,and FSL were 6.09%,5.60%,5.65%,respectively in AMI group.Intraobserver variabilities of the mean of Ds,D-mid,and FSL were 5.28%,4.83%,4.93% and interobserver variabilities of the mean of Ds,D-mid,and FSLwere 5.57%,5.42%,4.91%,respectively in control group. Conclusion：TMAD technology is a simple,accurate,and objective method,which can be used to evaluate the left ventricular global systolic function in patients with AMI.

关 键 词：心肌梗死 急性 超声描记术 二尖瓣 心室功能 左 

分 类 号：R542.2[医药卫生—心血管疾病]