斑点追踪技术评价左心室射血分数正常心力衰竭伴心房颤动患者左心室收缩功能  

Assessment of left ventricular systolic function in patients with atrial fibrillation and heart failure with normal ejection fraction by speckle tracking imaging

作　　者：李清[1] 陈海燕[2] 周年伟 舒先红[2] 潘翠珍[1] 葛均波[2] 

机构地区：[1]复旦大学附属中山医院上海市心血管病研究所心内科,上海200032 [2]复旦大学附属中山医院上海市心血管病研究所心超室,上海200032

出　　处：《中华超声影像学杂志》2014年第11期930-933,共4页Chinese Journal of Ultrasonography

摘　　要：目的应用二维、三维斑点追踪技术结合同步三平面超声显像技术、单心动周期实时三维超声显像技术，对左室射血分数正常心力衰竭伴心房颤动（房颤）患者的左室心肌节段收缩功能及节段收缩同步性进行评价。方法34例左室射血分数正常心力衰竭伴心房颤动患者为心力衰竭组，29例房颤不伴心力衰竭患者为对照组。应用双平面Simpson法测量左室射血分数，二维斑点追踪技术测量二维纵向、环向、径向应变，三维斑点追踪技术测量三维应变，评价并对比心力衰竭组及对照组左室心肌节段收缩功能和节段收缩同步性；应用组织多普勒显像、三平面二维斑点追踪技术及三维斑点追踪技术评价并比较两组间左室心肌节段收缩同步性。结果与对照组相比，心力衰竭组左室心肌节段纵向收缩力显著下降而径向收缩力代偿增强，心肌节段收缩显著不同步。结论二维、三维斑点追踪技术结合同步三平面超声显像技术、单心动周期实时三维超声显像技术优于组织多普勒技术，可早期评价左室射血分数正常的心力衰竭伴心房颤动患者的左室心肌节段收缩功能及节段收缩同步性。Objective To explore the left ventricular systolic function in patients with atrial fibrillation（AF） and heart failure with normal ejection fraction（HFnEF） using tri-plane 2D, 3D speckle tracking imaging （STI） and single-beat real-time three-dimensional ultrasound. Methods Thirty-four patients with AF and HFnEF were enrolled as HFnEF group and twenty-nine AF patients without any kind of heart failure as control group. Left ventricular ejection fraction （LVEF） was measured by hi-plane Simpson＇s method, regional systolic function of left ventricle was evaluated by 2D-STI and 3D-STI, and synchronism of left ventricle was assessed using tissue Doppler imaging （TDI）, tri-plane 2D-STI and 3I）- STI.Resnlts HFnEF group had higher two-dimensional longitudinal strain and lower two-dimensional radial strain.Left ventricular synchronism in HFnEF group was significantly poorer than that in control group. Conclusions 2D/3D STI is more sensitive than TDI and it can discover contractility abnormal and asynchronism in patients with both AF and HFnEF with the help of tri-plane imaging and single-beat real- time three-dimensional ultrasound.

关 键 词：超声心动描记术 心力衰竭 心房颤动 

分 类 号：R541.6[医药卫生—心血管疾病] R540.45[医药卫生—内科学]