超声心动图评价急性心肌梗死Ⅱ期心脏康复前后心功能及同步性  

Evaluation of the function and synchrony in patients with acute myocardial infarction after phaseⅡcardiac rehabilitation using echocardiography

作　　者：徐莉[1] 汪健飞[1] 郑枫[1] 黄艳 XU Li;WANG Jianfei;ZHENG Feng;HUANG Yan(Room of Echocardiography,the Affiliated People′s Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China;Cardiac Rehabilitation Centre,the Affiliated People′s Hospital of Jiangsu University,Zhenjiang Jiangsu 212002,China)

机构地区：[1]江苏大学附属人民医院心脏彩超室,江苏镇江212002 [2]江苏大学附属人民医院心脏康复中心,江苏镇江212002

出　　处：《江苏大学学报（医学版）》2023年第1期54-56,62,共4页Journal of Jiangsu University：Medicine Edition

摘　　要：目的:应用超声心动图评价急性心肌梗死患者行Ⅱ期心脏康复前后心功能及同步性改变。方法:对20例急性心肌梗死患者Ⅱ期心脏康复前后使用脉冲多普勒结合心电图计算主肺动脉射血前时间差,即心室间机械延迟时间(IVMD)。于心尖四腔心切面,使用M型超声心动图,计算出三尖瓣环收缩期位移(TAPSE)。使用实时三维超声心动图获取心尖四腔心全容积图像,在Qlab 9.0软件下获得心率、左室射血分数(LVEF)、左室舒张末容积(LVEDV)、左房最大容积(LAVmax)和左房射血分数(LAEF)。软件自动计算出左室16节段达收缩期最小容积点时间最大时间差(Tmsv16-Dif)心率校正值,即LVTmsv16-Dif/R-R(%),以及左房16节段达收缩期最小容积点时间最大时间差(Tmsv16-Dif)心率校正值,即LATmsv16-Dif/R-R(%)。结果:急性心肌梗死患者Ⅱ期心脏康复后心率、LATmsv16-Dif/R-R(%)明显低于康复前(P<0.001和P<0.05),LVEF、LAEF明显高于康复前(P<0.001和P<0.05),康复前后IVMD、TAPSE、LVEDV、LAVmax、LVTmsv16-Dif/R-R(%)比较差异无统计学意义(P均>0.05)。结论:急性心肌梗死患者行Ⅱ期心脏康复后左心收缩功能及左房同步性较康复前改善。Objective:Using echocardiography to evaluate the cardiac function and synchrony in patients with acute myocardial infarction before and after phaseⅡcardiac rehabilitation.Methods:Twenty patients with acute myocardial infarction(AMI)after phaseⅡcardiac rehabilitation were enrolled in the study.The time difference before ejection of aorta and pulmonary artery,also known as inter ventricular mechanical delay(IVMD),was calculated by pulse Doppler combined with electrocardiogram.The tricuspid annular plane systolic excursion(TAPSE)was calculated using M-mode echocardiography.Real-time three-dimensional echocardiography was performed to obtain full-volume images of apical 4 chambers.Heart rate(HR),left ventricular ejection fraction(LVEF),left ventricular end diastolic volume(LVEDV),left atrial maximal volume(LAVmax),left atrial ejection fraction(LAEF)were analyzed with Qlab 9.0 software,respectively.The time of left ventricle and left atrium to minimal systolic volume(Tmsv)of 16 segments and the maximal difference of corresponding segments(Tmsv16-Dif)were also obtained by Qlab 9.0 software.The above parameters as percentage of the cardiac cycle with different heart rates between patients were also calculated from the Qlab 9.0 software,which were LVTmsv16-Dif/R-R(%)and LATmsv16-Dif/R-R(%).Results:The HR and LATmsv16-Dif/R-R(%)in the post-rehabilitation were significantly lower than those in the pre-rehabilitation(P<0.001 and P<0.05).The LVEF and LAEF were significantly higher than those in the pre-rehabilitation(P<0.001 and P<0.05).There was no significant differences in IVMD,TAPSE,LVEDV,LAVmax and LVTmsv16-Dif/R-R(%)between before and after cardiac rehabilitation(P>0.05).Conclusion:Left heart systolic function and left atrial synchrony were improved in patients with acute myocardial infarction after phaseⅡcardiac rehabilitation.

关 键 词：超声心动图 心肌梗死 心脏康复 心功能 同步性 

分 类 号：R542.22[医药卫生—心血管疾病]