二维应变方法对左心室心肌机械运动特性的观察  

Mechanical motion characteristics of left ventricular myocardium in two-dimensional strain echocardiography

作　　者：章晨[1] 孙寅光[1] 朱佳[1] 黄洁[1] 王琳[1] 葛卫力[1] 唐礼江[1] 

机构地区：[1]温州医学院附属台州医院心血管内科,浙江台州317000

出　　处：《临床荟萃》2012年第4期284-288,F0002,共6页Clinical Focus

摘　　要：目的研究正常人心肌机械运动特性。方法研究对象为60例正常志愿者,男34例,年龄(42.0±13.0)岁;女26例,年龄(37.0±10.0)岁,应用超声心动图二维斑点成像技术评价左心室纵向、径向和圆周向运动的心肌机械运动参数,包括收缩应变、收缩应变率和舒张应变率及其达峰时间。结果左心室收缩应变纵向运动和圆周向表现出自基底部至心尖部收缩应变的绝对值递增,纵向运动基底部、中间部至心尖部收缩应变的绝对值分别为:20.2±4.2,20.4±4.3,22.5±6.4(P<0.05);圆周向运动基底部、中间部至心尖部收缩应变的绝对值分别为:20.1±7.7,23.4±8.1,27.1±7.1(P<0.01),而径向运动的表现则不同,基底部、中间部与心尖部收缩应变的绝对值分别为40.9±17.4,41.8±17.6,28.8±17.1(P<0.01);3个方向的收缩应变率表现完全不一致,没有明显规律。3个方向舒张早期应变率均表现为自基底部至心尖部递增的趋势。重复性检验提示纵向收缩峰值应变,重复性最佳。结论心肌机械运动是一个极其复杂的过程,二维应变超声心动图有助于揭示生理和病理状态下心肌运动特性。Objective To study myocardial characteristics of mechanical motion in normal subjects.Methods Sixty healthy volunteers were included,male 34 cases,aged（42.0±13.0） years;female 26 cases,aged（37.0±10.0） years,two-dimensional speckle imaging technique was used to measure the left ventricular myocardial longitudinal,radial and circumferential movement of mechanical motion parameters including systolic strain,systolic strain rate and diatolic strain rates,as well as time-to-peak.Results The performance of left ventricular radial motion was different in absolute strain value,compared to longitudinal and circumferential systolic strains which increased from the base to the apex.The absolute value of longitudinal strain from base to apex respectively was 20.2±4.2,20.4±4.3,22.5±6.4（P0.05）,while that in circumferential direction respectively 20.1±7.7,23.4±8.1,27.1±7.1（P0.01）,but radial motion was different,the absolute value of strain in three levels respectively was 40.9±17.4,41.8±17.6,28.8±17.1（P0.01）.The systolic strain rate in three directions was completely inconsistent,there was no obvious rule.There was a trend for early diastolic strain rate in three directions increasing from the base to the apex.The reproductivity test indicated the peak longitudinal strain was the best.Conclusion Cardiac mechanical movement is a very complicated process,two-dimensional strain echocardiography helps reveal the myocardial movement characteristics in physiological and pathological states.

关 键 词：心室功能 左 超声心动描记术 多普勒 运动 参考值 

分 类 号：R540.45[医药卫生—心血管疾病]