自动心肌运动定量技术评估频发室性期前收缩患者射频导管消融术后左心室功能的价值研究  

Automated cardiac motion quantification technique for evaluating left ventricular function in patients with premature ventricular contractions after radiofrequency catheter ablation

作　　者：肖莉莉[1] 寇红菊[1] 李秀云[1] 吴道珠[1] 宋静[2] XIAO Lili;KOU Hongju;LI Xiuyun;WU Daozhu;SONG Jing(Department of Ultrasonography,the Second Affiliated Hospital of Wenzhou Medical University,Wenzhou 325027,China)

机构地区：[1]温州医科大学附属第二医院超声科,325027 [2]温州医科大学附属第二医院心内科,325027

出　　处：《浙江医学》2021年第10期1056-1061,I0005,I0006,共8页Zhejiang Medical Journal

基　　金：温州市科技计划项目(Y20170816)。

摘　　要：目的探讨自动心肌运动定量(aCMQ)技术评估频发室性期前收缩(PVCs)患者射频导管消融术后左心室功能的价值。方法选取2018年1月至2019年3月温州医科大学附属第二医院频发PVCs患者26例为观察组,根据病程分为≤1年、>1年患者,各13例。并选取同期本院健康体检者30例为对照组。行超声心动图检测,获取两组对象左心房内径(LAD)、左心室舒张末内径(LVIDd)、左心室收缩末内径(LVESd)、左心室射血分数(LVEF)、二尖瓣舒张早期E峰速度和心房收缩期A峰速度比值(E/A)、二尖瓣舒张早期E峰速度与组织多普勒二尖瓣环(侧壁及室间隔)舒张早期平均e峰速度比值(E/e);并运用aCMQ技术获取两腔心纵向应变(AP2LS)、三腔心纵向应变(AP3LS)、四腔心纵向应变(AP4LS)及整体纵向应变(LVGLS),左心室短轴基底段环向应变(SAXBCS)、短轴中间段环向应变(SAXMCS)、短轴心尖段环向应变(SAXACS)及整体环向应变(LVGCS),进行分析比较。观察组射频导管消融术后6个月重复上述检查。结果观察组术前与对照组LVIDd、LVESd比较,差异均有统计学意义(均P<0.05)。观察组术前与术后LVIDd、LVESd比较,差异均有统计意义(均P<0.05)。>1年患者术前与术后LVIDd、LVESd比较,差异有统计学意义(均P<0.05)。观察组术前AP4LS、AP2LS、LVGLS、SAXMCS的绝对值较对照组低,差异均有统计学意义(均P<0.05)。观察组术前与术后AP4LS、LVGLS比较,差异均有统计学意义(均P<0.05)。>1年患者术前与术后AP3LS、AP4LS、LVGLS比较,差异均有统计学意义(均P<0.05)。≤1年患者术前与术后AP4LS差异有统计学意义(P<0.05)。结论aCMQ技术能发现频发PVCs早期隐匿性的心功能的改变,LVGLS、AP2LS、SAXMCS是较敏感可靠的评价指标。Objective To explore the value of automated cardiac motion quantification(aCMQ)in evaluating left ventricular function in patients with frequent premature ventricular contractions(PVCs)after radiofrequency catheter ablation.Methods From January 2018 to march 2019,26 patients with frequent PVCs in the Second Affiliated Hospital of Wenzhou Medical University were enrolled in the study(observation group).There were 13 cases with course≤1 year and 13 cases with course>1 year.At the same time,30 age and sex-matched healthy subjects were selected as the control group.The left atrial size(LAD),left ventricular end diastolic diameter(LVIDd),left ventricular end systolic diameter(LVESd),left ventricular ejection fraction(LVEF),diastolic function parameters E/A and E/e were measured by echocardiography.The main outcome assessments obtained by aCMQ technique were two chamber longitudinal strain(AP2LS),three chamber longitudinal strain(AP3LS),four chamber longitudinal strain(AP4LS)and global longitudinal strain(LVGLS).Circumferential strains in three different levels of left ventricular short axis,including basal level circumferential strain(SAXBCS),papillary muscle level circumferential strain(SAXMCS),apical level circumferential strain(SAXACS)and global circumferential strain(LVGCS)were also obtained.In PVC patients the above examinations were repeated 6 months after radiofrequency catheter ablation.Results Among the parameters obtained by echocardiography,there were significant differences in LVIDd and LVESd between control group and observation group be-fore operation(all P<0.05).There were significant differences in LVIDd and LVESd in patients and controls before and after operation(all P<0.05).There were significant differences in LVIDd and LVESd in patients with course>1 year before and after operation(all P<0.05);while there was no statistical difference in all above parameters in patients with course≤1 year before and after operation(all P>0.05).Among the parameters obtained by aCMQ technique,the absolute values

关 键 词：自动心肌运动定量 室性期前收缩 射频导管消融 

分 类 号：R541.7[医药卫生—心血管疾病]