肥厚型心肌病左心室整体与节段纵向收缩功能及同步性的组织运动瓣环位移研究  

A research of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy by tissue motion annular displacement

作　　者：左蕾[1] 刘丽文[1] 拓胜军[2] 孙艳丹[3] 周晓东[1] 杨丽平[1] 齐伟[1] 马斌[1] 

机构地区：[1]第四军医大学西京医院超声科,西安710032 [2]延安市人民医院超声科 [3]解放军第四五一医院超声科

出　　处：《中华超声影像学杂志》2012年第12期1017-1021,共5页Chinese Journal of Ultrasonography

基　　金：陕西省社发攻关项目（2012k15-01-03）

摘　　要：目的采用组织运动瓣环位移技术（TMAD）定量分析肥厚型心肌病（HCM）患者左室整体与节段纵向收缩功能及同步性，探讨其应用价值和可行性。方法连续选择非梗阻型肥厚型心肌病患者（nHCM）39例，同期选择性别、年龄相匹配的健康人39例作为对照组。采用二维斑点追踪技术（2D-STI）测量左室整体与节段纵向应变（LSR）以及采用QLAB8．1软件测量二尖瓣环6个位点（室间隔，侧壁，前间隔，后壁，前壁和下壁）二尖瓣环位移（MAD）以及达峰时间，计算二尖瓣环整体位移（MADlob．-）以及左心室收缩期不同步化指数（SDI）。分析LSR与MAD的相关性，比较两组MAD、SDI等参数。结果TMAD有效跟踪节段数显著高于STI（98．7％对77．9％，P〈0．001）。TMAD测量MAD与STI测量左室节段纵向应变（r=-0．784，P〈0．001）和整体应变（r=-0．897，P〈0．001）显著相关。与对照组比较，nHCM患者左室六个位点MAD以及MADglob^l均显著减低（P均〈0．001），SDI显著增加（P〈0．001）。结论TMAD是评价nHCM患者左室纵向整体与节段收缩功能以及同步性的新方法。Objective To evaluate the value and feasibility of tissue mitral annular displacement （TMAD） in the assessment of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy. Methods The study population consisted of 39 on-obstructive hypertrophic cardiomyopathy （nHCM） patients and 39 healthy volunteers matched by gender and age. Left ventricular global and segmental longitudinal were measured by speckle tracking imaging（STI）. The mitral annular displacement （MAD） （anterioseptal, posterioseptal, anterior, lateral, posterior and inferior sites, respectively）, peak of time （PT） and left ventricular systolic dyssynchrony index （SDI） were measured by TMAD. The correlation between LSR and MAD was analyzed,and the parameters of MAD and SDI for tow groups were compared. Results The rate of effectively track segments of TMAD was significantly higher than that of STI（98.7 % vs 77.9 %, P %0. 001）. There were high correlationship between segmental LSR and MAD（ r = - 0. 784, P %0. 001） ,and global and MADgloB,2 （ r = - 0. 897, P 0. 001）. Compared with the control group, MAD of six spots and MADglob.l were significantly decreased （P 〈 0. 001 ,respectively） ,SDI was significantly increased（ P〈0. 001）. Conclusions TMAD is a sensitive and reproducible method for the assessment of LV longitudinal functionin patients with nHCM.

关 键 词：超声心动描记术 心肌病 肥厚性 心室功能 左 

分 类 号：R542.2[医药卫生—心血管疾病]