斑点追踪显像技术评价肥厚型心肌病患者心肌应变的研究  

Evaluation of myocardial strain in the patients with hypertrophic cardiomyopathy by speckle tracking imaging

作　　者：陈昕晔[1] 郭薇[2] 

机构地区：[1]福建医科大学附属福州市第一医院超声影像科,福建福州350000 [2]福建省立医院超声科,福建福州350001

出　　处：《中国现代医生》2017年第6期109-112,F0003,共5页China Modern Doctor

摘　　要：目的应用二维斑点追踪显像(2DSTI)技术评价肥厚型心肌病患者的心肌应变特点。方法选择正常对照组30例,肥厚型心肌病组30例。应用STI技术测定左心室各壁基底段、中间段和心尖段收缩期峰值应变(Ss),并对检测结果进行分析。结果与对照组比较,肥厚型心肌病组室间隔增厚(P<0.05),肥厚型心肌病组心肌纵向应变值在左室基底段和中间段、心尖段均较对照组低(P<0.05)。直线相关分析显示各组间LVEF与收缩期纵向峰值应变之间均存在正相关(r=0.589、0.797)。IVS在对照组与收缩期纵向峰值应变之间无明显相关性,但在肥厚型心肌病组与收缩期纵向峰值应变之间呈负相关(r=-0.538)。结论在肥厚型心肌病患者的整体左室收缩功能减低之前,其左室各节段心肌应变改变已经出现,STI可以发现患者早期局部左室功能的改变。肥厚型心肌病患者的收缩期峰值应变与其LVEF水平呈正相关,与IVS厚度呈负相关。应用二维斑点追踪显像技术测量肥厚型心肌病患者收缩期左室纵向应变值,有助于了解患者心脏收缩时心肌纵向运动和应变值的变化情况,能够判断和评价局部心肌功能。Objective To evaluate the characteristics of myocardial strain in the patients with hypertrophic cardiomyopathy by two-dimensional speckle tracking imaging （2DSTI）. Methods A total of 30 cases in normal control group and 30 cases in hypertrophic cardiomyopathy group were selected. STI technique was used to determine the systolic peak strain （Ss） of basal segment, middle segment and apical segment of left ventricular walls, and the results were analyzed. Results Compared with the control group, the interventricular septum in the hypertrophic cardiomyopathy group was thickening （P〈0.05）. The longitudinal strain of myocardium in the hypertrophic cardiomyopathy group was lower than that in the control group in the basal segment, middle segment and apical segment of left ventricle （P〈0.05）. Linear eor relation analysis showed a positive correlation between LVEF and longitudinal systolic peak strain in each group （r= 0.589, 0.797, respectively）. There was no significant correlation between IVS and longitudinal systolic peak strain in the control group; there was a negative correlation between IVS and the longitudinal systolic peak strain in the hyper trophic eardiomyopathy group （r=-0.538）. Conclusion Before the reduction of left ventricular systolic function in the patients with hypertrophic cardiomyopathy, the changes of myocardial strain in all segments of left ventricle have appeared. STI is able to detect early changes of regional left ventricular function in the patients. The systolic peak strain in the patients with hypertrophic cardiomyopathy is positively correlated with LVEF level and negatively correlated with IVS thickness. Application of two-dimensional speckle tracking imaging technique to measure the left ventricular longitudinal strain in the patients with hypertrophic eardiomyopathy can help to understand the changes of myocardial longitudinal motion and strain in cardiac contraction, and can judge and evaluate regional myocardial function.

关 键 词：二维斑点追踪 肥厚型心肌病 收缩期峰值应变 局部心肌功能 

分 类 号：R542.2[医药卫生—心血管疾病]