二维超声斑点追踪成像评价心脏移植术后左心室整体扭转及解旋运动的初步研究  

Evaluation of left ventricular bulk rotation and untwisting in transplanted hearts using two-dimensional speckle tracking imaging： a preliminary study

作　　者：尤君[1] 韩伟[1] 谢明星[1] 覃小娟[1] 方凌云[1] 卢晓芳[1] 武彧[1] 

机构地区：[1]华中科技大学同济医学院附属协和医院超声影像科,武汉430022

出　　处：《中华超声影像学杂志》2013年第12期1017-1021,共5页Chinese Journal of Ultrasonography

摘　　要：目的运用二维超声斑点追踪成像技术评价心脏移植术后左室整体扭转及解旋运动改变。方法心脏移植术后3个月患者15例和健康志愿者56例。二维超声获取受检者左室基底水平及心尖水平短轴切面图像。二维超声斑点追踪成像显示各平面旋转角度随心动周期变化的曲线，行相关指标测量并比较。结果①与正常对照组相比，心脏移植组心率增快，左房前后径增大，室间隔及左室后壁增厚，等容舒张时间延长，二尖瓣环室间隔侧舒张期e值、a值减低，E／e值增大，差异有统计学意义（P＜0．05）。②两组左室整体扭转差异无统计学意义（P〉0．05）。两组于主动脉瓣关闭、二尖瓣开放时间点处的扭转角度及左室峰值扭转角度差异均元统计学意义（分别P=0．984，0．495，0．700）。正常对照组与心脏移植组左室整体扭转达峰时间均在收缩末期附近，差异无统计学意义[（96．1±8．4）％对（100．5±6．3）％，P=0．065]。③心脏移植组等容舒张期左室解旋率及一系列趋势检验参数与正常对照组相比明显减低，差异均有统计学意义（P＜0．001）。结论心脏移植术后3个月左室整体扭转功能正常；等容舒张期左室解旋率及系列趋势检验参数减低，提示移植心脏术后早期左室舒张功能受损。Objective To evaluate the changes of left ventricular （LV） bulk rotation and untwisting in transplanted hearts using 2-dimensional speckle tracking imaging（STI）. Methods Basal and apical LV short-axis images were acquired in 15 heart transplant recipients 3 months post surgery（HT group） and 56 healthy control subjects. Basal and apical rotation versus time profiles were drawn using 2-dimensional STI software. Appropriate values were chosen from the dataset obtained and compared between two groups. Results ①Compared with the control group,the heart rate, anterior-posterior diameter of left atrium, end-diastolic interventricular septum thickness, left ventricular posterior wall thickness, isovolumic relaxation time and E/e ratio were significantly increased, e and a values were decreased significantly in HT group （P ①0.05）. ② No significant difference was noticed in the peak degrees of LV bulk rotation,the degrees of LV bulk rotation at the time of aortic valve closure and mitral valve opening （ P = 0. 700 , 0. 984 , 0. 495 , respectively） between 2 groups. In both groups, systolic rotation reached its maximum at end-systole [（95.1 ± 8.4） % in HT group vs （100.5 ± 6.3） % in control group, P = 0. 065]. ③Significant decreases in untwisting rate and trend untwisting variables were observed in the HT group（ P 〈0. 001）. Conclusions 3 months after transplanted, left ventricular bulk rotation of cardiac allografts remained normal, and significant decreases in both untwisting rate and trend untwisting variables showed that the diastolic function of cardiac allografts was impaired.

关 键 词：超声心动描记术 心脏移植 心室功能 左 斑点追踪显像 

分 类 号：R654.2[医药卫生—外科学]