三维斑点追踪成像评价左室心肌致密化不全患者左心室收缩功能的初步研究  

Assessment of regional and global systolic function of left ventricular in patients with left ventricular noncompaction by three-dimensional speckle tracking imaging

作　　者：傅庆美 吕清[1] 谢明星[1] 王新房[1] 杨亚利[1] 邱林立[1] 周桦[1] 石波波 

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

出　　处：《中华超声影像学杂志》2014年第12期1017-1021,共5页Chinese Journal of Ultrasonography

摘　　要：目的 应用三维斑点追踪成像（3D-STI）评价左室心肌致密化不全（LVNC）患者左室局部及整体收缩功能.方法 双平面Simpson法测量左室射血分数≥50％ LVNC患者23例,与病例组匹配的健康人23例.病例组在二尖瓣、乳头肌、心尖三个水平按该节段是否受累分为非致密节段组及致密节段组,对照组三个水平按与病例组相对应的同水平同节段分为对照组1及对照组2.三维超声心动图采集心尖四腔观左室全容积数据并储存,3D-STI技术测量并比较左室整体圆周应变（GCS）、整体径向应变（GRS）、整体纵向应变（GLS）及左室各节段（16节段）圆周应变（rCS）、径向应变（rRS）、纵向应变（rLS）.结果 ①病例组GCS、GRS、GLS均较对照组显著下降（P＜0.01）;②心尖、乳头肌水平非致密节段组及致密节段组rCS、rRS、rLS均较同水平相对应对照组1及对照组2下降（P＜0.05）;③心尖水平非致密节段与致密节段组间rRS、rLS差异具有统计学意义（P＜0.05）.结论 左室射血分数正常的LVNC患者早期收缩功能已受损,以心尖及乳头肌水平为主,且致密心肌节段、非致密心肌节段收缩功能均受损,心尖水平非致密心肌纵向及径向应变下降更明显.Objective To evaluate regional and global systolic function of left ventricular using three-dimensional speckle tracking imaging （3D-STI） in patients with left ventricular non-compaction（LVNC）.Methods Twenty-three patients with LVNC were included,all patients＇ left ventricular ejection fraction （LVEF） ≥50％ assessed by two-dimensional echocardiography,and twenty-three healthy subjects were enrolled in the study.The wall segments of the 23 patients with LVNC were divided into two groups：group of compacted segments and group of noncompacted segments.Corresponding to the two groups of LVNC patients according to one-by-one matching rule,all wall segments of 23 control subjects were divided into two paired groups （control group 2 and control group 1）.The apical four-chamber view full-volume images of left ventricle were acquired by 3D-STI and were stored in dynamic mode.Global circumferential strain （GCS）,global radial strain（GRS）,global longitudinal strain（GLS） and segmental （16 segments） regional circumferential strain（rCS）,regional radial strain（rRS）,regional longitudinal strain（rLS） were recorded.Results ① Compared with the control group,GCS,GRS,GLS decreased significantly in the patients group （P ＜0.01）.② Compared with control group 1 and group 2,rCS,rRS,rLS decreased in apical and the middle of noncompacted and compacted LV segments,the difference was significant （P ＜0.05）,and no difference in basal segments（P ＞0.05）.③ Compared with compacted segments,rRS,rLS in the noncompacted segments decreased significantly in apical.Conclusions Cardiac function of LVNC patients were already impaired mainly in apical and the middle segments when the values of LVEF was normal,Systolic function impaired both in noncompacted and compacted LV segments in apical and the middle,noncompacted and compacted LV segments in apical had comparable decreased rLS and rRS.

关 键 词：超声心动描记术 三维 心室肌致密化不全 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R542.2[医药卫生—内科学]