超声心动图在定量评价急性心肌梗死患者短期内双房重构与形变中的应用  

Evaluation of atrial remodeling and deformation in patients with acute myocardial infarction using echocardiography

作　　者：廖康腊[1] 高电萨[1] 廖慧[1] 秦检 

机构地区：[1]重庆医科大学附属第一医院心内科,重庆400016

出　　处：《临床心血管病杂志》2015年第12期1275-1278,共4页Journal of Clinical Cardiology

摘　　要：目的:探讨超声心动图定量评价急性心肌梗死后患者双房的重构情况及形变能力。方法:选取我院确诊为急性心肌梗死患者(AMI组)61例及32例经心电、冠状动脉(冠脉)CT或造影检查排除冠心病的患者(对照组),心脏超声检查测得双房内径,最大、最小及收缩前容积(VFilaX、Vmin及Vp),计算双心房被动射血分数(LAPEF/RAPEF)及主动射血分数(LAAEF/RAAEF);留取动态图像进行二维斑点追踪脱机分析,获取双房备节段房壁左室收缩期的纵向峰值应变(LS)、应变率(SRs)、左室舒张早期峰值应变率(Sre)与左室舒张晚期峰值应变率(Sra)。并计算其平均峰值应变率(mSRs、mSRe、mSRa)。结果:与对照组比较,AMI组短期内双房重构无显著差异,双房主动射血分数显著增高(P<0.05),双房被动射血分数显著减低(P<0.05);mSRs、mSRe绝对值均减低(均P<0.05),mSRa绝对值增高(P<0.05)。结论:AMI早期双房均开始发生重构,但双房形变比容积变化更显著,二维斑点追踪应变成像能早期、敏感地定量评价AMI后双房功能的变化。Objective：To evaluate atrial remodeling and deiormation in patients with acute myocardial miarction using echocardiography.Method：Sixty-one acute myocardial infarction patients（AMI group） and 32 patients without coronary heart disease（control group） were selected.The atrial diameter,maximal,minimal and pre-systolic volume（Vmax,Vmin and Vp）,atrial passive ejection fraction（LAPEF/RAPEF）,atrial active ejection fraction（LAAKF/RAAKF） were measured by echocardiography.The systolic,early and late diastolic peak strain rate（Ssr,Esr and Asr） curves and left ventricular systolic longitudinal peak strain（LS） were acquired in LA/RA each segment by 2D-STI.The average strain rate（mSRs,mSRe,mSRa） was calculated.Result：The atrial remodeling in a short period in AMI group had no significant difference compared with control group,the LAPEF/RAPEF,mSRs,mSRe were significantly decreased（P〈0.05）,while the LAAEF/RAAEF,mSRa significantly increased（P〈0.05）.Conclusion：Atrial remodeling occurs in the early stage of acute myocardial infarction,but atrial deformation is more obvious than the volume change,thus 2D-STI can quantitatively evaluate the changes of atrial function in acute myocardial infarction patients in the early stage and with high sensitivity.

关 键 词：斑点追踪显像 急性心肌梗死 心房功能 

分 类 号：R541.4[医药卫生—心血管疾病]