实时三维超声心动图和二维斑点追踪技术对冠心病患者左心室收缩同步性的评价  

Evaluation Left Ventricular Systolic Synchrony in Patients With Coronary Heart Disease by Real-time 3D Echocardiography and 2D Speckle Tracking Imaging

作　　者：张小花[1] 姜志荣[1] 孙安华 韩素华 

机构地区：[1]山东省青岛大学附属医院东院区心脏超声科,青岛市266003 [2]东营市人民医院超声科

出　　处：《中国超声医学杂志》2016年第10期901-904,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的探讨左室扭转、左心室壁力学与容积间关系在评价冠心病患者左心室收缩同步性方面的临床应用价值。方法 26例心肌梗死患者、24例心肌缺血患者和30例正常对照者分别行二维斑点追踪(2D-STI)、实时三维超声心动图(RT-3DE)检查。2D-STI获得左心室16、12节段收缩期纵向、径向、环向应变及旋转角度标化达峰时间(Tls-16%、Trs-12%、Tcs-12%、Trot-12%)及心底与心尖部收缩期旋转角度标化达峰时间(Tbase%、Tapex%)等左心室壁力学时间指标。RT-3DE获得左心室容积时间指标(Tmsv-16%),计算两者时间差(Tlsv%、Trsv%、Tcsv%、Trotv%)及心底与心尖部收缩期旋转达峰时间差(Tabrot%)。结果缺血组Tls-16%、Tmsv-16%、Tlsv%较对照组延长,差异有统计学意义(P<0.05);心肌梗死组上述时间指标均较缺血组和对照组延长,差异均有统计学意义(P<0.05)。结论左心室扭转、左心室壁力学与容积间的关系均可评价心肌梗死患者左心室收缩不同步性。Tlsv%可早期检测心肌缺血患者左心室收缩不同步性。Objective To explore the clinical value of left ventrieular （LV） torsion, the relationship of LV wall mechanics and volume with LV systolic synchrony in patients with coronary heart disease. Methods 26 myocardial infarction patients, 24 myocardial ischemia patients and 30 normal subjects examined by 2D speckle tracking imaging （2D-STI） and real-time 3D echocardiography （RT-3DE）, retrospectively, The time parameters of LV wall mechanics such as standardized times to peak longitudinal strain of 16 LV segments （Tls-16 % ）, standardized times to peak radial strain of 12 LV segments （Trs-12%）, standardized times to peak circumferential strain of 12 LV segments （Tcs- 12%）, standardized times to peak rotation of 12 LV segments （Trot-12%）, standardized time to peak rotation of LV base （Tbase %） and LV apex （Tapex%） were obtained from 2D-STI. The standardized time to minimum systolic volume 16 LV segments （Tmsv-16%） was obtained from RT-3DE. The differences of Tls% to Tmsv% （Tlsv%）, Trs% to Tmsv% （Trsv%）, Tcs% to Tmsv% （Tcsv%）, Trot% to Tmsv% （Trotv%）, and the time interval of rotation between apex and base （Tahrot%） were calculated respectively. Results Compared with control group, Tls-16%, Tmsv-16%, Tlsv% were significantly prolonged in myocardial ischemia group（P〈0.05）. Compared with myocardial isehemia group and control group, all the above time parameters had significantly difference in myocardial infarction group（P〈0. 05）. Conclusions LV torsion, the relationship of LV wall mechanics and volume all can assess LV systolic asynchrony in myocardial infarction patients. Tlsv% can early evaluate LV systolic asynchrony in myocardial ischemia patients.

关 键 词：实时三维超声心动图 二维斑点追踪显像 力学 容积 同步性 

分 类 号：R540.45[医药卫生—心血管疾病] R541.4[医药卫生—内科学]