二维斑点追踪技术评价心脏淀粉样变性患者左心室收缩功能及同步性改变  

Assessment of Left Ventricular Function and Synchrony in Cardiac Amyloidosis by Two-dimensional Speckle Tracking Echocardiography

作　　者：丁雪晏 吕秀章[1] 李一丹[1] 孙兰兰[1] 叶晓光[1] 蔡绮哲[1] 朱维维[1] Ding Xueyan;Lü Xiuzhang;Li Yidan;Sun Lanlan;Ye Xiaoguang;Cai Qizhe;Zhu Weiwei(Department of Echocardiography,Beijing Chaoyang Hospital,Capital Medical Clniversity,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院心脏超声科,北京市100020

出　　处：《中国超声医学杂志》2020年第7期625-628,共4页Chinese Journal of Ultrasound in Medicine

基　　金：1351人才培养计划(No.CYMY-2017-28)。

摘　　要：目的应用二维斑点追踪超声心动图(2D-STE)评价心脏淀粉样变性(CA)患者左心室收缩功能及同步性改变。方法选取确诊的CA患者20例(CA组)和健康志愿者20例(对照组)进行超声心动图检查。应用2D-STE测量两组受试者左心室整体长轴应变(GLS)、17节段长轴应变达峰时间(TTPLS)及达峰时间标准差(MD),计算左心室基底段、中间段及心尖段平均TTPLS(TTPLSbase、TTPLSmid和TTPLSapex),经心动周期RR间期标化后以百分数表示。结果与对照组相比,CA组GLS减低、MD%明显增大(P<0.001),TTPLSbase%、TTPLSmid%延长(P<0.05),TTPLSapex%无明显差异(P>0.05)。CA组不同左心室水平TTPLS呈逐渐延长趋势,但仅TTPLSbase%与TTPLSapex%存在统计学差异(P=0.045)。MD%与GLS呈正相关(r=0.586,P=0.013)。结论CA患者左心室长轴形变能力受损,运动同步性减低。2D-STE评价CA患者左心室收缩功能和同步性改变可能为临床评估病情提供参考依据。Objective To evaluate the changes of left ventricular(LV)systolic function and synchrony in cardiac amyloidosis(CA)patients by two-dimensional speckle tracking echocardiography(2 D-STE).Methods 20 patients with diagnosed CA(CA group)and 20 healthy volunteers were prospectively enrolled.2 D-STE was used to obtain LV global longitudinal strain(GLS),the 17-segmental time to peak longitudinal strain(TTPLS)and mechanical dispersion(MD).The mean TTPLS of LV basal,middle and apical segments were calculated.Then,the indices after standardization(MD%,TTPLSbase%,TTPLSmid%and TTPLSapex%)were recorded.Results Compared with control group,GLS was declined and MD%was significantly increased(P<0.001),TTPLSbase%and TTPLSmid%were prolonged(P<0.05).However,TTPLSapex%had no significant difference(P>0.05).Although in CA group,TTPLSapex%,TTPLSmid%and TTPLSbase%were gradually prolonged,but only TTPLSapex%and TTPLSbase%had statistical difference(P=0.045).MD%was positively correlated with GLS(r=0.586,P=0.013).Conclusions LV longitudinal deformation and synchrony was impaired in CA patients.Assessment of Left ventricular systolic function and synchronization by 2 D-STE in CA patients may provide a reference for clinical evaluation.

关 键 词：斑点追踪超声心动图 心脏淀粉样变性 心室功能 同步性 

分 类 号：R445.1[医药卫生—影像医学与核医学] R541[医药卫生—诊断学]