RT-3DE联合2D-STI评估肥厚型梗阻性心肌病患者经皮室间隔消融术后左心功能变化  

Assessment of Left Heart Function After Percutaneous Transluminal Spetal Myocardial Ablation in Patients with Hypertrophic Obstructive Cardiomyopathy by RT-3DE Combined with 2D-STI

作　　者：姜峰 盛红专[2] 耿海华[2] 陆晓晨[2] Jiang Feng;Sheng Hongzhuan;Geng Haihua;Lu Xiaochen(Cardiac Ultrasound Room,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China;Department of Cardiology,Affiliated Hospital of Nantong University,Nantong,Jiangsu 226001,China)

机构地区：[1]南通大学附属医院心脏超声室,江苏省南通市226001 [2]南通大学附属医院心内科,江苏省南通市226001

出　　处：《中国超声医学杂志》2022年第10期1110-1114,共5页Chinese Journal of Ultrasound in Medicine

基　　金：南通市市级科技项目(No.MS22020008)。

摘　　要：目的 应用实时三维超声心动图(RT-3DE)联合二维斑点追踪技术(2D-STI)探讨肥厚型梗阻性心肌病(HOCM)患者经皮室间隔消融(PTSMA)术前及术后左心功能的变化。方法 选择35例于南通大学附属医院行PTSMA术HOCM患者作为研究对象,分别于术前、术后1周及术后6个月行RT-3DE及2D-STI检查,测量左心室大小和射血分数(EDV、ESV、LVEF)、不同时相左心房容积(LAVImax、LAVImin、LAVIp)和应变(Ss、Se、Sa),并计算左心房排空分数(LAEI、LApEI、LAaEI)、平均峰值应变(mSs、mSe、mSa)及应变率(mSRs、mSRe、mSRs)。结果 与PTSMA术前相比,术后1周时,LVEF、 LAVImax、LAVImin、LAVIp显著减低,差异有统计学意义(P<0.05);术后6个月时,LAVImax、LAVImin、LAVIp进一步减低,EDV、ESV、LApEI、mSs、mSe、mSa、mSRs、mSRe、mSRs则明显升高,差异有统计学意义(P<0.05),而LVEF与术前无统计学意义(P>0.05)。结论 HOCM患者PTSMA术后6个月时,左心室功能恢复,左心房功能得到改善。RT-3DE联合2D-STI可准确定量HOCM患者PTSMA术后左心功能的改变。Objective To investigate the changes of left heart function before and after percutaneous transluminal spetal myocardial ablation(PTSMA) in hypertrophic obstructive cardiomyopathy(HOCM) patients using real-time three-dimensional echocardiography(RT-3 DE) and two-dimensional speck tracking(2 D-STI). Methods Thirty-five HOCM patients undergoing PTSMA in Affiliated Hospital of Nantong University were selected as the research subjects. RT-3 DE and 2 D-STI examinations were performed before operation, 1 week after operation and 6 months after operation.Left ventricular size and ejection fraction(EDV, ESV, LVEF), left atrial volume(LAVImax, LAVImin, LAVIp) and strain(Ss, Se, Sa) were measured. Left atrial emptyfraction(LAEI, LApEI, LAaEI), average peak strain(mSs, mSe, mSa) and strain rate(mSRs, mSRe, mSRs) were calculated. Results Compared with before PTSMA, LVEF, LAVImax, LAVImin and LAVIp were significantly decreased 1 week after operation, and the differences were statistically significant(P<0.05).Six months after operation, LAVImax, LAVImin and LAVIp were significantly decreased, while EDV, ESV, LApEI, mSs, mSe, mSa, mSRs, mSRe and mSRs were significantly increased, the difference was statistically significant(P<0.05), while LVEF was not significantly different from that before operation(P>0.05). Conclusions At 6 months after PTSMA in HOCM patients, left ventricular function recovered and left atrial function improved. RT-3 DE combined with 2 D-STI can accurately quantify the changes of left heart function after PTSMA in HOCM patients.

关 键 词：肥厚型心肌病 心肌消融 三维超声 左心功能 

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]