斑点追踪成像评价主动脉瓣狭窄患者TAVI后心室功能的价值  

The Value of Speckle Tracking Imaging in Evaluating Ventricular Function in Patients with Aortic Stenosis After TAVI

作　　者：马晓[1] 唐国璋[1] 陈晓菲 赵亮[1] 孙娟娟[1] 宫坤[1] 付秀秀[1] Ma Xiao;Tang Guozhang;Chen Xiaofei;Zhao Liang;Sun Juanjuan;Gong Kun;Fu Xiuxiu(Department of Cardiac Ultrasound,Affiliated Hospital of Qingdao University,Qingdao,Shandong 266000,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东省青岛市266000

出　　处：《中国超声医学杂志》2023年第8期891-894,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用斑点追踪成像(STI)评价重度主动脉瓣狭窄(AS)患者经皮主动脉瓣置换术(TAVI)前后的心室应变,进而评估重度AS患者术前、术后的心室功能。方法选取重度AS患者30例,对照组另选取30例健康人。STI测量左右心室整体纵向应变(GLS)及左、右心室舒张末和收缩末容积,并计算左室射血分数(LVEF)及右心室面积变化分数(FAC),比较术前、术后各参数差异,绘制箱式图观察右心室GLS的变化趋势。结果与对照组相比,重度AS患者BNP、LVEDd、LVEDs、A、E/e′术前及术后均处于升高状态,差异有统计学意义(P<0.05);与TAVI前相比,术后1周及1个月LVEDd、A、E/e′减低,LVGLS、LVGCS、LVEF、RVGLS均升高,差异有统计学意义(P<0.05)。与术前及术后1周相比,术后1个月BNP减低,差异有统计学意义(P<0.05)。结论斑点追踪成像可有效评估TAVI前后左右心室心肌功能,GLS可作为早期评估指标。Objective To evaluate the ventricular strain and ventricular function in patients with severe aortic stenosis(AS)before and after transcatheter aortic valve implantation(TAVI)by speckle tracking imaging(STI).Methods Thirty patients with severe AS were selected,and 30healthy people were selected as the control group.Left and right ventricular global longitudinal strain(GLS),left and right ventricular end-diastolic and end-systolic volume were measured by STI,and left ventricular ejection fraction(LVEF)and right ventricular fractional area change(FAC)were calculated.The differences of each parameter before and after intervention were compared,and the box plot was drawn to observe the change trend of right ventricular GLS.Results Compared with the control group,BNP,LVEDd,LVEDs,A and E/e′in patients with severe AS were increased before and after operation,and the difference was statistically significant(P<0.05).Compared with the pre-operational data,LVEDd,A and E/e′decreased,LVGLS,LVGCS,LVEF and RVGLS increased at 1week and 1month post-operation,and the difference was statistically significant(P<0.05).Compared with the data pre-operation and 1week post-operation,brain natriuretic peptide(BNP)level at 1month after operation were decreased,and the difference was statistically significant(P<0.05).Conclusions Speckle tracking imaging can be effectively used to evaluate the left and right ventricular myocardial function before and after TAVI,and GLS can be used as an early assessment index.

关 键 词：斑点追踪成像 主动脉狭窄 心室功能 应变 

分 类 号：R654.2[医药卫生—外科学]