实时三维超声心动图斑点追踪技术评价移植心脏左心室收缩功能  

Left ventricular systolic function evaluated by real-time three-dimensional speckle tracking echocardiography in heart transplant recipients

作　　者：刘红云[1] 邓又斌[1] 刘琨[1] 李阳[1] 汤乔颖[1] 魏翔[2] 昌盛[3] 卢峡[3] 

机构地区：[1]华中科技大学同济医学院附属同济医院超声影像科,武汉430030 [2]华中科技大学同济医学院附属同济医院心脏大血管外科,武汉430030 [3]华中科技大学同济医学院附属同济医院器官移植研究所,武汉430030

出　　处：《中华超声影像学杂志》2013年第6期475-479,共5页Chinese Journal of Ultrasonography

基　　金：华中科技大学自主创新研究基金资助项目（20i2QN183）

摘　　要：【摘要】目的应用实时三维超声心动图斑点追踪技术检测移植心脏左室壁峰值收缩应变，探讨实时三维超声心动图斑点追踪技术评价移植心脏左室收缩功能的价值。方法23例接受心脏移植患者于移植术后1月、2月、3月进行超声心动图检查，共57次。23例正常人作为对照。采集左室的三维全容积图像，应用EchoPAc软件进行分析，获取左室壁各节段及左室壁整体的应变曲线及应变值，记录左室壁整体峰值纵向应变、圆周向应变、面积应变及径向应变并进行统计学分析。结果心脏移植患者术后与正常对照者的左室射血分数及心输出量差异无统计学意义，左室壁整体峰值纵向应变在术后1月较正常组显著减低，术后2月及3月与正常组的差异无统计学意义；左室壁整体峰值圆周向应变、面积应变、径向应变在术后1月、2月、3月均较正常组显著减低。结论移植心脏虽然左室射血分数值表现“正常”，但左室整体峰值应变仍较正常人减低。实时三维超声心动图斑点追踪技术可较准确地评价移植心脏左室收缩功能。Objective To evaluate the left ventricular systolic function in the cardiac allograft by real- time three-dimensional speckle tracking echocardiography. Methods Twenty-three heart transplant recipients underwent total 57 echocardiographie studies at one, two, three months after heart transplantation. Twenty-three healthy subjects were served as controls. The three-dimensional full volume images of left ventricle were recorded and then were analyzed using EchoPAC software. The strain curves were obtained and peak strain values of left ventricle for each segment and overall left ventricular wall were measured. Left ventricular global peak longitudinal strain （GPSL）, circumferential strain （GPSC）, area strain （GPSA） and radial strain （GPSR） were recorded and then statistical analyzed. Results The left ventrieular ejection fraction （EF） and cardiac output （CO） in heart transplant recipients had no significant difference when compared with controls. The GPSL reduced significantly one month after surgery in heart transplant recipients than controls, but had no significant difference two months and three months after surgery with controls. The GPSC, GPSA, GPSR decreased significantly in heart transplant recipients （one, two, three months after surgery） than those in controls. Conclusions The left ventricular ejection fraction of cardiac allograft seemed ＂normal＂ ,but the global peak strain of left ventricle were still significantly reduced than controls. Real-time three dimensional speckle tracking echocardiography can be used for an accurate assessment of left ventricular systolic function in heart transplant recipients.

关 键 词：超声心动描记术 实时三维 心脏移植 心室功能 左 斑点追踪显像 

分 类 号：R445.1[医药卫生—影像医学与核医学]