实时三平面组织同步成像评价老年心肌梗死患者左心室内及心室间运动不同步  

Application of triplane TSI in assessing left intraventricular and interventricular asynchrony in ederly MI patients

作　　者：邓玉姣 陈薇 黄鑫[2] 王光磊[3] 王一茹[1] 罗渝昆[1] Deng Yujiao;Chen Wei;Huang Xin;Wang Guanglei;Wang Yiru;Luo Yukun(Department of Ultrasonography,Chinese PLA General Hospital No.1 Medical Center,Beijing100853,China)

机构地区：[1]解放军总医院第一医学中心超声科,北京100853 [2]解放军总医院第二医学中心心内科,北京100853 [3]解放军总医院医疗保障中心,北京100853 [4]北京卫戍区丰台第十六离职干部休养所门诊部

出　　处：《中华老年心脑血管病杂志》2020年第10期1036-1040,共5页Chinese Journal of Geriatric Heart,Brain and Vessel Diseases

摘　　要：目的应用实时三平面组织同步成像技术评价老年心肌梗死患者左心室内及左右心室间运动不同步。方法选择2017年8月~2019年12月解放军总医院第一医学中心心内科临床确诊的急性心肌梗死患者71例,根据冠状动脉造影结果分为左冠状动脉病变组39例(共计546节段,其中左心室468节段),以左前降支和(或)左回旋支闭塞或严重狭窄为主;右冠状动脉病变组32例(共计448节段,其中左心室384节段),以右冠状动脉闭塞或严重狭窄为主。另随机选择健康志愿者30例作为对照组(共计420节段,其中左心室360节段)。测量各节段收缩期达峰时间(Ts),计算左心室12节段Ts的标准差和最大差值(Ts-SD、Ts-maxD)及左右心室收缩延迟(L-RV-D)。结果对照组左心室心肌运动表现为较均匀分布的绿色,极少数节段呈黄、绿色。左冠状动脉病变组和右冠状动脉病变组左心室心肌Ts彩色编码呈绿、黄、橙、红浓度分布不均。与对照组比较,左冠状动脉病变组左心室前壁、前侧壁、后侧壁、前间隔Ts明显升高,右冠状动脉病变组左心室下壁、后间隔和右心室侧壁Ts明显升高,差异有统计学意义(P<0.05)。与对照组比较,左冠状动脉病变组和右冠状动脉病变组左心室12节段Ts-SD、Ts-maxD明显升高,且左冠状动脉病变组左心室12节段Ts-SD、Ts-maxD明显高于右冠状动脉病变组[(47.95±10.16)ms vs(35.62±7.03)ms,P<0.05;(149.72±27.51)ms vs(107.55±19.23)ms,P<0.05],L-RV-D明显低于右冠状动脉病变组[-(57.42±45.19)ms vs(48.26±29.57)ms,P<0.05]。结论三平面组织同步成像能够定性、定量观测收缩运动延迟的心肌节段,定量评价左心室内及左、右心室间运动不同步。Objective To assess the left intraventricular asynchrony,left and right interventricular asynchrony in elderly myocardial infarction patients with triplane tissue synchronization imaging.Methods Seventy-one elderly myocardial infarction patients admitted to our hospital from August 2018to December 2019were divided into left coronary artery lesion group(n=39)with 546 segments involved(including 468left ventricular segments)and right coronary artery lesion group(n=32)with 448segments involved(including 384left ventricular segments),and 30 healthy volunteers served as a control group with 420segments involved(including 360left ventricular segments).The time to peak contraction velocity(Ts)was recorded.The standard deviation of Ts(Ts-SD),maximal difference of Ts(Ts-max D),left-right ventricular contraction delay(L-RV-D)were calculated.Results The left ventricular myocardial motion was evenly distribued as green segments with very few yellow segments observed in control group.The color coding of left ventricular myocardial Ts showed unevenly distributed green,yellow,orange and red segments in left coronary artery lesion group and right coronary artery lesion group.The Ts in left ventricular anterior wall,anterior-lateral wall,posterior-lateral wall,anterior septum,inferior wall,posterior septum and in right ventricular lateral wall septum was significantly longer in left coronary artery lesion group than in control group(P<0.05).The Ts-SD in 12left ventricular segments was significantly longer and the Ts-max D in 12left ventricular segments was significantly greater in left coronary artery lesion group and right coronary artery lesion group than in control group and in left coronary artery lesion group than in right coronary artery lesion group(47.95±10.16ms vs 35.62±7.03ms,P<0.05;149.72±27.51ms vs 107.55±19.23ms,P<0.05).The L-RV-D was significantly shorter in right coronary artery lesion group than in control group(-57.42±45.19ms vs 48.26±29.57ms,P<0.05).Conclusion Triplane tissue synchronization imaging can qu

关 键 词：心肌梗死 心肌收缩 心肌缺血 心室功能 左 超声心动描记术 

分 类 号：R542.22[医药卫生—心血管疾病]