三维斑点追踪超声心动图定量评价成人肥厚型心肌病早期左室心肌收缩力学变化  

Evaluation of the left ventricular myocardial mechanics and synchronicity by three-dimensional speckle tracking echocardiography in the adult patients with early-stage hypertrophic cardiomyopathy

作　　者：纳丽莎 贾梅 朱睿 李晴 周丽 黄璇 潘璐 NA Lisha;JIA Mei;ZHU Rui;LI Qing;ZHOU Li;HUANG Xuan;PAN Lu(The General Hospital of Ningxia Medical University,Yinchuan 750004,China;Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学总医院心脏中心功能检查部超声心动图室

出　　处：《宁夏医学杂志》2019年第12期1060-1063,共4页Ningxia Medical Journal

基　　金：国家自然科学基金资助项目(81760318)

摘　　要：目的应用三维斑点追踪超声心动图(3D-STE)技术定量评价成人肥厚型心肌病(HCM)患者早期左室心肌收缩应变、扭转运动功能及其同步性。方法选取30例宁夏地区成人HCM患者为HCM组,另选性别、年龄相匹配的30例正常人为对照组。常规经胸超声测量室间隔舒张末期厚度(IVSD)及左室后壁舒张末期厚度(LVPWD)、左室射血分数(LVEF)等参数;利用X5-1矩阵探头获取左室三维全容积动态图像,运用脱机软件TomTec 4D LV-Analysis 3.0获得左心室整体圆周应变(GCS)、左心室整体纵向应变(GLS)、左心室整体径向应变(GRS)、左心室基底段旋转角度(Rotation-basal)、左心室心尖段旋转角度(Rotation-apical)、左心室扭转角度(Twist)、左心室扭力(Torsion)、基底段旋转达峰时间(Pti-basal)、心尖段旋转达峰时间(Pti-apical)以及整体扭转达峰时间(Pti-twist),比较2组上述各参数之间的差异。结果 HCM组LAD、IVSD、LVPWD、EDV、ESV以及SV值明显高于对照组(P<0.05),而LVEF值较对照组减低(P<0.05),E/A差异无统计学意义(P>0.05);3D-GLS、3D-GCS和3D-GRS相比对照组明显减低(P<0.05);Rotation-basal、Rotation-apical、Twist和Torsion与对照组相比明显增加(P<0.05);Pti-basal、Pti-apical与Pti-twist较对照组减低但差异无统计学意义(P>0.05)。结论 3D-STE技术可以定量、准确评价成人HCM患者早期左室心肌收缩应变、扭转运动功能及其同步性,为临床早期诊断与及时干预治疗提供重要参考依据。Objective To evaluate the left ventricular(LV) strain,torsion functions and synchronicity by three-dimensional speckle tracking echocardiography(3 D-STE) in adult patients with early-stage hypertrophic cardiomyopathy(HCM).Methods A total of 30 patients with early-stage HCM were enrolled. In addition,30 healthy subjects were recruited as a control group. Interventricular septal thickness(IVSD) and left ventricular posterior wall thickness(LVPWD),left ventricular ejection fraction(LVEF) and other parameters were measured by conventional transthoracic echocardiography.Full-volume three-dimensional dynamic images were performed by using matrix transducer X5-1.Left ventricular basal segment rotation angle(Rotation-basal),left ventricular apical segment rotation angle( Rotation-apical),left ventricular torsion angle( Twist),left ventricular torsion( Torsion),left ventricular global circumferential strain( GCS),left ventricular global longitudinal strain( GLS) and left ventricular global radial strain( GRS),time to peak of basal segment rotation( Pti-basal),time to peak of apical segment rotation( Pti-apical),time to peak of twist( Pti-twist) were analyzed by off-line Tom Tec software. The differences of those parameters between the two groups were compared. Results LAD,IVSD,LVPWD,EDV,ESV and SV in the HCM group were significantly higher than those in the control group( P < 0. 05) and LVEF was decreased compared with the control group( P < 0. 01),and the E/A difference between the two groups was not statistically significant( P <0. 05). In the HCM group,3 D-GLS,3 D-GCS and 3 D-GRS were decreased significantly( P < 0. 05). Rotation-basal,Rotation-apical,Twist and Torsion were significantly increased( P < 0. 05). Pti-basal,Pti-apical and Pti-twist were decreased but the differences were not statistically significant( P > 0. 05) compared with the control group. Conclusion 3 D-STE can quantitatively and accurately evaluate the changes of left ventricular strain,torsion functions and synchronicity in adult patients with earl

关 键 词：肥厚型心肌病 心室心肌 应变 扭转 同步性 三维斑点追踪成像 超声心动图 

分 类 号：R540.4[医药卫生—心血管疾病]