三维斑点追踪在评价肥厚型心肌病患者左室整体收缩功能中的应用  

Evaluation of left ventricular systolic function in patients with hypertrophic cardiomyopathy by three dimensional speckle tracing

作　　者：何嘉辉 郑智超[1] 姜惠悦 傅建群 曾嘉欣 He Jiahui;Zheng Zhichao;Jiang Huiyue;Fu Jianqun;Zeng Jiaxin(Department of Ultrasound,Nanhai Hospital,Guangdong Provincial People’s Hospital,Foshan 528251,China)

机构地区：[1]广东省人民医院南海医院超声科

出　　处：《广西医科大学学报》2019年第7期1108-1112,共5页Journal of Guangxi Medical University

基　　金：佛山市卫生局基金资助项目(No.20190279)

摘　　要：目的:探究三维斑点追踪(3D-STI)在评价肥厚型心肌病(HCM)患者左室整体收缩功能中的应用效果。方法:选取2016年9月至2018年8月广东省人民医院南海医院收治的45例HCM患者作为观察组,根据肥厚部位不同分为室间隔肥厚型(sHCM)24例,心尖肥厚型(aHCM)7例,混合型(mHCM)14例,另选取同期健康体检者45例作为对照组。两组均于常规超声心动图检查后行3D-STI检查,对比两组左室舒张末期室间隔最大厚度(IVSd)、左心室收缩期整体纵向峰值应变(GPLS)、面积峰值应变(GPAS)、圆周峰值应变(GPCS)、径向峰值应变(GPRS),并分析HCM患者应变参数与IVSd的相关性及各节段应变情况。结果:两组GPCS无明显差异(P>0.05);观察组GPLS、GPAS、GPRS均较对照组低,IVSd较对照组高(均P<0.05);Pearson相关分析显示,HCM患者GPCS、GPLS、GPAS与IVSd呈正相关关系(r=0.591、0.864、0.816,均P<0.05),GPRS与IVSd呈负相关关系(r=-0.720,P<0.05);心肌应变减低sHCM亚组多集中于间隔的中间与基底段,aHCM亚组多集中于心尖段,mHCM亚组多集中于心尖段与中间段,同时还有部分非肥厚节段心肌应变减低。结论:3D-STI可更为直观、简便地反映HCM患者受损心肌收缩功能,其参数GPLS联合GPAS可更为准确的评估HCM患者左室整体收缩功能。Objective: To investigate the effect of three-dimensional speckle tracking (3D-STI) in evaluating left ventricular global systolic function in patients with hypertrophic cardiomyopathy (HCM). Methods: A total of 45 HCM patients admitted to our hospital from September 2016 to August 2018 were selected as an observation group,which were divided into 24 cases of ventricular septal hypertrophy (sHCM),7 cases of cardiac apical hypertrophy (aHCM) and 14 cases of mixed type (mHCM) according to different parts of hypertrophy.Another 45 cases of healthy people during the same period were selected as the control group.All patients underwent 3D-STI after conventional echocardiography.The left ventricular end-diastolic maximum interventricular septum thickness (IVSd),left ventricular systolic longitudinal longitudinal peak strain (GPLS),area peak strain (GPAS),circumferential peak strain (GPCS),and radial peak strain (GPRS) were compared between the two groups.The correlation between strain parameters and IVSd of HCM patients and strain conditions of each segment were analyzed. Results: There was no significant difference in GPCS between the two groups ( P >0.05).The GPLS,GPAS and GPRS in the observation group were lower than those in the control group,and the IVSd was higher ( P <0.05).Pearson correlation analysis showed that GPCS,GPLS and GPAS of HCM patients were positively correlated with IVSd ( r =0.591,0.864,0.816, P <0.05),while GPRS was negatively correlated with IVSd ( r =-0.720, P <0.05).Myocardial strain reduction sHCM subgroup was mostly concentrated in the middle of the interval and basal segment,and aHCM subgroup was mostly concentrated in the apex segment,the mHCM subgroup was mostly concentrated in the apical segment and the middle segment,and there was also a decrease in myocardial strain in some non-hypertrophic segments. Conclusion: 3D-STI can reflect the impaired myocardial systolic function in HCM patients more visually and simply,and the parameters of GPLS combined with GPAS can more accurately evaluate

关 键 词：三维斑点追踪 肥厚型心肌病 左室整体收缩功能 左室舒张末期 面积峰值应变 圆周峰值应变 径向峰值应变 

分 类 号：R542.2[医药卫生—心血管疾病] R445.1[医药卫生—内科学]