超声心动图斑点追踪技术对致心律失常性右室心肌病的诊断及预测价值  

Diagnostic and predictive value of echocardiographic speckle tracking technique in arrhythmogenic right ventricular cardiomyopathy(ARVC)

作　　者：周敏[1,2] 刘圣[1] 雍永宏[1] 姬后亮[2] 刘剑秋 姜爽爽[2] ZHOU Min;LIU Sheng;YONG Yong-hong;JI Hou-liang;LIU Jian-qiu;JIANG Shuang-shuang(Department of cardiology,First Affiliated Hospital,Nanjing Medicai University,Nanjing 210029,Jiangsu,China;Department of Function,Nanjing Pukou Hospital of TCM,Nanjing 211800,Jiangsu,China)

机构地区：[1]南京医科大学第一附属医院心脏科,江苏南京210029 [2]南京市浦口区中医院功能科,江苏南京211800

出　　处：《心脏杂志》2020年第4期389-393,共5页Chinese Heart Journal

基　　金：江苏省人力资源和社会保障厅2015年度“六大高峰人才”D类项目资助(2015-WSN-037)。

摘　　要：目的研究超声心动图及斑点追踪技术在致心律失常性右室心肌病(ARVC)诊断中的应用价值。方法选择2017年1月至2019年6月我院收治的60例ARVC患者作为病例组,选择同时期来我院体检的60例健康人作为对照组。比较两组的基本临床资料,进行心脏彩色超声多普勒及斑点追踪技术检查,观察超声心动图主要表现、右心室侧壁各节段在心肌收缩期的峰值及应变率。病例组根据ARVC病情级别分为3个亚组,Ⅱ级组29例、Ⅲ级组21例、Ⅳ级组10例,比较3个亚组各节段右心室侧壁各节段心肌收缩期峰值速度及应变率。结果病例组右心室侧壁各节段在心肌收缩期的峰值速度及应变率均明显低于对照组(P<0.05);病例组3个亚组右心室侧壁的基底段、中段及心尖段在心肌收缩期的峰值速度及应变率均为Ⅱ级组>Ⅲ级组>Ⅳ级组(P<0.05)。不同心肌节段峰值速度、应变率对致心律失常性右室心肌病均有一定对诊断价值,中段心肌应变率对致心律失常性右室心肌病的诊断价值最高,曲线下面积高达0.905(0.612-0.978)。结论超声心动图及斑点追踪技术可检测心室结构、心肌收缩功能及运动能力的变化,对ARVC的早期诊断及预测病情程度均具有重要价值。AIM To study the value of echocardiography and speckle tracking in the diagnosis of ARVC.METHODS 60 ARVC patients admitted to our hospital from January 2018 to December 2019 were selected as the observation group,and 60 healthy patients who came to our hospital for physical examination during the same period were selected as the control group.The basic clinical data of the two groups were compared,and the echocardiographic findings,peak value and strain rate of each segment of the lateral wall of the right ventricle during myocardial systolic period were observed by color doppler and speckle tracking technique.The observation group was divided into 3 subgroups according to the grade of ARVC,including 29 patients in the gradeⅡgroup,21 patients in the gradeⅢgroup,and 10 patients in the gradeⅣgroup.Peak systolic velocity and strain rate of each segment of right ventricular lateral wall were compared in 3 subgroups.RESULTS The peak velocity and strain rate of each segment of the lateral wall of the right ventricle in myocardial systolic period of the observation group were significantly lower than that of the control group(P<0.05).The peak velocity and strain rate of the basal segment,middle segment and apex segment of the right ventricular lateral wall in the observation group of 3 subgroups were all in the gradeⅡ>gradeⅢ>Ⅳgroup during the period of myocardial systole(P<0.05).The peak velocity and strain rate of different myocardial segments have certain value in the diagnosis of arrhythmogenic right ventricular cardiomyopathy.The middle myocardial strain rate has the highest value in the diagnosis of arrhythmogenic right ventricular cardiomyopathy,and the area under the curve is as high as 0.905(0.612-0.978).CONCLUSION Echocardiography and speckle tracking technology detects the changes of ventricular structure,myocardial systolic function and motor ability,which is of great value for the early diagnosis of ARVC and the prediction of the severity of ARVC.

关 键 词：超声心动图及斑点追踪技术 致心律失常性右室心肌病 诊断价值 

分 类 号：R725.4[医药卫生—儿科]