二尖瓣环位移自动追踪技术评价心脏淀粉样变性患者左心室收缩功能  

Automated motion tracking of mitral annular displacement in evaluation on left ventricular systolic function in patients with cardiac amyloidosis

作　　者：张晶[1] 任卫东[1] 郭宝生[1] 肖杨杰[1] 宋光[1] 潘福治[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国医学影像技术》2013年第8期1322-1326,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨组织运动二尖瓣环位移自动追踪(TMAD)技术评估心脏淀粉样变性(CA)患者左心室收缩功能的临床价值。方法收集经心外组织活检证实的CA患者21例(CA组)及年龄匹配的健康志愿者26名(对照组),行常规超声心动图检查并存储心尖四腔心切面二维图像,以Simpson法测量左心室射血分数(LVEF),采用QLab 8.1工作站自动获取二尖瓣环位移(MAD)后室间隔瓣环插入点最大位移(MADsep)、侧壁瓣环插入点最大位移(MADlat)、瓣环连线中点的最大位移(MADmid)以及MADmid占舒张期左心室长径的百分比(MADmid%);分析CA患者各MAD参数与LVEF的相关性。结果 CA组LVEF、MADsep、MADlat、MADmid及MADmid%均低于对照组(P均<0.001);CA组MADsep、MADlat、MADmid及MADmid%与LVEF均呈正相关(P均<0.001),以MADmid%与LVEF相关性最好(r=0.840)。结论 TMAD是一种简单、准确、客观评价CA患者左心室收缩功能的新方法。Objective To explore the value of tissue motion tracking of mitral annular displacement （TMAD） in evaluation on left ventricular systolic function in patients with cardiac amyloidosis （CA）. Methods Twenty-one patients with CA （CA group） confirmed by extracardiac biopsy and 26 age-matched healthy subjects （control group） were enrolled and underwent routine echocardiography, and the apical four-chamber view images were recorded. The left ventricular ejection fraction （LVEF） was calculated by biplane Simpson method, and the mitral annular displacement （MAD） of interventricular septum （MADsep）, left ventricular lateral wall （MADlat） and middle point of mitral annulus （MADmid） were measured using QLab 8.1 workstation. MADmid% was defined as MADmid divided by left ventricular end-diastolic diameter. In CA patients, the correlation between parameters of MAD and LVEF were analyzed. Results Compared with control group, LVEF, MADsep, MADlat, MADmid and MADmid% decreased significantly in CA group （all P〈0.001）. There was significantly positive correlation between LVEF and MADsep, MADlat, MADmid, as well as MADmid% in CA group （all P〈0.001）, and MADmid% had the strongest correlation （r=0.840）. Conclusion TMAD is a simple, accurate, objective and new promising method in evaluation on left ventricular systolic function in patients with CA.

关 键 词：淀粉样变性 二尖瓣环位移 超声心动描记术 心室功能 左 

分 类 号：R541.8[医药卫生—心血管疾病] R540.45[医药卫生—内科学]