二维应变参数评价扩张型心肌病患者左心室收缩同步性及其与心功能的关系  

Assessment of left ventricular dyssynchrony and its relationship with cardiac function in dilated cardiomyopathy by two-dimensional strain parameters

作　　者：梅丹娥 陈金玲[1] 冯闯丽 赵志玉[1] 宋宏宁[1] 

机构地区：[1]武汉大学人民医院超声科,湖北武汉430060

出　　处：《中国医学影像技术》2017年第9期1339-1343,共5页Chinese Journal of Medical Imaging Technology

基　　金：湖北省卫计委青年人才项目(WJ2015Q016)

摘　　要：目的探讨二维斑点追踪成像(2D-STI)应变参数评价扩张型心肌病(DCM)患者左心室收缩同步性的价值及其与心功能的关系。方法收集DCM患者(DCM组)及对照组各25例,采用2D-STI技术获取左心室各节段纵向应变达峰时间、圆周应变达峰时间(Tls、Tcs),分别计算左心室18节段纵向应变达峰时间标准差(Tls-SD)及最大差值(Tls-dif),左心室心尖四腔心、三腔心、二腔心切面6节段纵向应变达峰时间标准差(Tls-SD-4、Tls-SD-3、Tls-SD-2)及最大差值(Tlsdif-4、Tls-dif-3、Tls-dif-2),左心室18节段圆周应变达峰时间标准差(Tcs-SD)及最大差值(Tcs-dif),左心室短轴二尖瓣、乳头肌、心尖水平6节段圆周应变达峰时间标准差(Tcs-SD-M、Tcs-SD-P、Tcs-SD-A)及最大差值(Tcs-dif-M、Tcs-dif-P、Tcsdif-A)。结果与对照组比较,DCM组整体及节段应变参数均显著增大(P均<0.05);DCM组中,除Tcs-dif-P、Tcs-dif外,余应变参数均与左心室射血分数呈负相关(P均<0.05);除Tcs-dif-M、Tcs-dif-P及Tcs-dif外,余应变参数均与舒张早期二尖瓣口峰值血流速度(E)/二尖瓣环运动速度(e)呈正相关(P均<0.05)。结论 DCM患者左心室整体及局部收缩期应变均存在不同步,收缩不同步可加剧心功能的恶化;2D-STI参数可以客观评价DCM患者左心室收缩不同步及其与心功能的关系。Objective To explore value of two-dimensional speckle tracking imaging（2D-STI）strain parameters in assessment of left ventricular（LV）dyssynchrony and its relationship with cardiac function in patients with dilated cardiomyopathy（DCM）.Methods Totally 25 patients with DCM and 25age-matched normal controls were enrolled.The LV time to peak longitudinal strain（Tls）and time to peak circumferential strain（Tcs）were measured by 2D-STI,from which the standard deviations and maximal differences of the Tls in all 18 segments,6segments at apical 4-chamber,3-chamber and2-chamber views（Tls-SD,Tls-SD-4,Tls-SD-3,Tls-SD-2,Tls-dif,Tls-dif-4,Tls-dif-3,Tls-dif-2）were calculated,as same as the standard deviations and maximal differences of Tcs in all 18 segments,6segments at mitral valve,papillary muscle,apical short-axis views（Tcs-SD,Tcs-SD-M,Tcs-SD-P,Tcs-SD-A,Tcs-dif,Tcs-dif-M,Tcs-dif-P,Tcs-dif-A）were calculated.Results Compared with the control group,the global and segmental strain parameters of the DCM group increased significantly（all P〈0.05）.Except for Tcs-dif-P and Tcs-dif,the residual strain parameters were negatively correlated with LV ejection fraction（all P〈0.05）.Except for Tcs-dif-M,Tcs-dif-P and Tcs-dif,there was a positive correlation between strain parameters and E/e in DCM group（all P〈0.05）.Conclusion In patients with DCM,LV dyssynchrony exists both in global and regional,which may aggravates the LV function damage.2D-STI strain parameters can objectively evaluate LV dyssynchrony and its relationship with cardiac function in patients with DCM.

关 键 词：超声检查 心肌病 扩张型 心室功能 左 不同步 

分 类 号：R541[医药卫生—心血管疾病] R445.1[医药卫生—内科学]