三维超声斑点追踪成像技术分析扩张型心肌病患者左心室扭转与心肌纤维化的相关性  

To investigate the correlation between left ventricular twist and myocardial fibrosis in patients with dilated cardiomyopathy using three-dimensional speckle tracking echocardiography

作　　者：迟文 徐洪高[1] 高继康[2] 孙建忠[3] CHI Wen;XU Honggao;GAO Jikang;SUN Jianzhong(Department of Radiology,the First People's Hospital of Yuhang,Hangzhou 311100,China;不详)

机构地区：[1]杭州市余杭区第一人民医院放射科,311100 [2]杭州市余杭区第一人民医院超声科,311100 [3]浙江大学医学院附属第二医院放射科

出　　处：《心电与循环》2022年第3期241-244,共4页Journal of Electrocardiology and Circulation

摘　　要：目的应用三维超声斑点追踪成像技术(3DSTE)探讨扩张型心肌病(DCM)患者左心室扭转与心肌纤维化程度的相关性。方法选择2018年3月至2021年2月杭州市余杭区第一人民医院收治的DCM患者38例为观察组,同期健康体检者30例作为对照组,行心脏磁共振(CMR)检查,使用钆延迟强化序列(LGE)观察左心室心肌纤维化。行超声心动图检查,测量左心室舒张末期内径(LVEDd)、左心房前后径(LAD)、室间隔厚度(IVSd)、左心室后壁厚度(LVPWd),应用3DSTE检查,测定左心室扭转角度峰值(LV-Ptw)和左心室整体扭力(LV-t)。结果观察组心肌纤维化25例,无心肌纤维化13例。观察组LVEDd、LAD均大于对照组,LV-Ptw、LV-t均小于对照组(均P<0.05)。DCM伴心肌纤维化患者LV-Ptw、LV-t均与心肌纤维化程度呈负相关(r=-0.828、-0.841,均P<0.05)。结论通过3DSTE测定左心室扭转运动可估测DCM心肌纤维化程度。Objective To investigate the correlation between left ventricular twist and the degree of myocardial fibrosis in patients with dilated cardiomyopathy(DCM)by three-dimensional speckle tracking echocardiography(3DSTE).Methods A total of 38 patients with DCM treated in the First People’s Hospital of Yuhang were selected as observation group from March 2018 to January 2021.Thirty healthy subjects were selected as control group.Cardiac magnetic resonance(CMR)with late gadolinium enhancement was performed to determine myocardial fibrosis.Echocardiography was performed to measure left ventricular(LV)end diastolic diameter(LVEDd),left atrial diameter(LAD),interventricular septal thickness(IVS)and LV posterior wall thickness(LVPWT).3DSTE was performed to measure peak LV twist angle(LV-Ptw)and LV torsion(LV-t).Results Myocardial fibrosis was detected in 25 cases and not in 13 cases in observation group.LVEDd and LAD were larger in the observation group than in the control group,LV-Ptw and LV-t were lower in the observation group than in the control group(all P<0.05).LV-Ptw and LV-t in DCM patients with myocardial fibrosis were negatively correlated with the degree of myocardial fibrosis(r=-0.828,-0.841,both P<0.05).Conclusion The degree of myocardial fibrosis in DCM may be estimated based on LV twist dynamics measured by3DSTE.

关 键 词：超声心动图 三维斑点追踪成像 左心室功能 扩张型心肌病 心肌纤维化 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]