应变率成像对正常儿童左心室心肌形变能力的定量研究

目的 定量研究我国正常儿童左心室心肌应变率参数及其随年龄变化的特点。方法 正常儿童92名，按年龄分为4组，应用GEVivid7超声仪及Q-analyze软件分别对各组儿童左心室侧壁、下壁、前壁、后壁及前、后室间隔心肌各节段进行应变率定量分析。结果 前3组（1～9岁）儿童左心室心肌应变率在各节段的分布不一致，差异有统计学意义;10～14岁组左心室心肌各节段收缩期和舒张早期应变率差异无统计学意义，呈均衡分布。结论 正常儿童左心室心肌各节段收缩期、舒张早期应变率随年龄增长逐渐趋向一致，10岁后分布模式与成人相似。     

速度向量成像技术在慢性肾脏疾病早期左心室无肥厚构型患者局部心肌功能评价中的作用

目的:探讨速度向量成像(VVI)技术检测慢性肾脏疾病(CKD)早期患者左心室舒缩功能早期变化的价值。方法:选取30例左心室正常构型CKD早期患者(A组)和30例向心性重构CKD早期患者(B组),以30名健康体检者为对照(C组)。常规超声测定左心室舒张末期内径(LVIDd)、室间隔厚径(IVST)、左心室后壁厚径(LVPWT)、左心室射血分数(LVEF)、二尖瓣口舒张期血流频谱E、A比值;VVI技术测定左心室长轴16节段收缩期峰值应变率(SSRMAX)、舒张早期、晚期峰值应变率(DSRMAX/e、DSRMAX/n),进行各组之间的参数比较。结果:3组间LVEF差异无统计学意义。B组的E/A值低于C组及A组(均P0.05)。B组部分局部心肌节段SSRMAX及舒张早期DSRMAX/e低于A组和C组(均P0.05);A组舒张早期部分局部心肌节段DSRMAX/e低于C组(P0.05),而A、C两组SSRMAX各个节段心肌间无明显差异;3组间各节段心肌舒张晚期DSRMAX/n无统计学差异。结论:VVI技术可以定量评价左心室局部功能,尽早发现CKD早期患者节段心肌舒缩功能变化。     

应变率成像评价扩张型心肌病左室局部心肌收缩和舒张功能

目的 应用应变率成像(SRI)技术评价扩张型心肌病(DCM)患者左心室局部心肌长轴方向收缩和舒张功能.方法 获取18例DCM患者和40例正常对照组心尖左室长轴、心尖两腔、心尖四腔的心肌应变率曲线,测量并比较两组各室壁各节段水平的收缩期、舒张早期、舒张晚期的峰值应变率(SRs、SRe、SRa).测量左室射血分数(LVEF)和二尖瓣口血流的E峰、A峰.结果 DCM组各节段水平的SRs、SRe、SRa明显低于正常对照组(P＜0.05或P＜0.01).结论 SRI技术能准确可靠地评价DCM患者左室局部心肌收缩和舒张功能.     

应变率成像对冠心病左室心肌功能的分析

目的 应用应变率成像分析比较正常对照组与冠心病组的梗死、缺血、正常节段的收缩期应变率,舒张早期应变率、舒张晚期应变率的变化,以期找出冠心病患者在应变率成像中的表现特征及一般规律,以达到早期、准确发现诊断冠心病.方法 用应变率成像分析99例冠心病患者及92例正常对照组左室各心肌节段收缩期应变率、舒张早期应变率、舒张晚期应变率,并进行统计学分析.结果 冠心病组梗死心肌节段的收缩期应变率、舒张早期应变率均较正常对照组相应明显减低,有统计学意义;冠心病组心肌缺血节段的收缩期应变率较正常对照组明显减低,有统计学意义,而舒张早期应变率仅有39%的节段与正常对照组比较有统计学意义;冠心病组正常心肌节段的各期应变率及心肌梗死组、心肌缺血的舒张晚期应变率与对照组比较均无统计学意义.结论 应变率成像能够准确、早期诊断冠心病.     

二维斑点追踪成像技术对二尖瓣关闭不全成形术患者左心功能的研究

目的应用二维斑点追踪成像技术(2D-STI)测量二尖瓣成形术患者左室各节段心肌应变值,探讨2D-STI定量评价二尖瓣成形术患者心功能的临床价值。方法选取行二尖瓣成形术患者25例,在术前(A组)、术后1周(B组)、术后6个月(C组),分别对其进行常规超声心动图测量,包括:左房径(LAD)、左室舒张末内径(LVIDd)、左室射血分数(LVEF)。采集标准切面分别测量各组患者各节段心肌收缩期峰值纵向应变(LS)、径向应变(RS)、网周应变(CS)值。选取25例健康志愿者作为对照组(N组),两组间各参数进行比较。结果(1)术后各期LVEF与术前LVEF比较,差异无统计学意义。B、C组与A组比较,LAD、LVIDd均下降,差异有统计学意义(均为P<0.05);(2)A组与N组各节段比较,纵向峰值应变明显减低(均为P<0.05);B组与A组比较,各节段纵向峰值应变变化不明显(均为P>0.05);C组与A组各节段比较,收缩期纵向峰值应变有所增加(均为P<0.05);(3)基底水平及乳头肌水平A组与N组比较,收缩期峰值圆周应变明显减低(均为P<0.01);(4)左室短轴乳头肌水平B、C组与A组比较,径向应变峰值均增加(均为P<0.05);C组基底水平及乳头肌水平各节段峰值径向应变均基本接近N组,差异无统计学意义(均为P>0.05)。结论2D-STI在左室整体收缩功能改变以前能够早期发现左室局部心肌收缩功能异常,斑点追踪成像技术能够定量评价二尖瓣成形术患者左心功能的改变。     

应变率成像技术评价柔红霉素化疗对ALL患儿左心功能的影响

将36例急性淋巴细胞白血病(ALL)患儿(观察组)按照柔红霉素(DNR)化疗累积量是否超过200mg/m2分为A、B两组,用应变率成像(SRI)技术检测其化疗前后及正常对照组的左心功能.结果显示,观察组E/A、左室短轴缩短率、左室射血分数均低于对照组(但无统计学差异),二尖瓣环舒张早期运动速度/舒张晚期运动速度低于对照组(P<0.05).A组左室心肌的收缩期峰值应变率(SPSR)及舒张期峰值应变率(EDPSR)均明显低于对照组(P均<0.05),A、B组化疗前后SPSR及EDPSR均无统计学差异.提示SRI技术可较敏感地监测DNR对ALL患儿左心功能的损害.     

速度向量成像技术对原发性高血压颈动脉管壁运动的评价

目的 观察原发性高血压患者颈总动脉管壁短轴平面运动速度、应变及应变率的特点.方法 选取原发性高血压患者60例,按血压水平分为HP1组(血压140～159/90～99 mmHg)、HP2组(血压160～179/100～109 mmHg)和HP3组(血压≥180/110 mmHg),每组20例,以健康志愿者20例为对照组.采用速度向量成像技术(VVI)测量颈总动脉管壁短轴平面各壁收缩期最大径向运动速度(Vs)、最大切向应变(Smax)及最大切向应变率(Srmax).结果 对照组和HP1组内Vs各壁间(除前壁与外侧壁、内侧壁与后壁之间)比较均有显著性差异(P<0.05),前壁、外侧壁Vs 高于内侧壁、后壁;HP2组和HP3组Vs各壁间无显著性差异.各高血压组与对照组比较,各组间Vs HP3相似文献   

左心室收缩期心肌应变对原发性高血压心肌功能的预测价值

目的 探讨左心室收缩期心肌应变对原发性高血压心肌功能的预测价值。方法 选择原发性高血压患者78例,其中左心室肥厚（LVH）33例（LVH组）、非LVH 45例（NLVH组）,同期选择体检健康的志愿者50例（对照组）。所有研究对象入组后自愿接受二维超声心动图检查,常规测量左心房内径（LAD）、舒张末期室间隔厚度（IVSTd）、舒张末期左心室后壁厚度（LVPWTd）,计算左心室质量指数（LVMI）,在心尖四腔心切面测量二尖瓣口舒张早期峰值流速/舒张晚期峰值流速（E/A）,采用改良双平面Simpson法检测左心室射血分数（LVEF）。采用二维斑点追踪成像技术测量左心室收缩期纵向、径向、周向应变。采用受试者工作特征（ROC）曲线分析左心室收缩期整体纵向、径向、周向应变对LVH的预测效能。结果 NLVH组和LVH组LAD、IVSTd、LVPWTd、LVMI显著高于对照组,E/A显著低于对照组（P均<0.05）;LVH组LAD、IVSTd、LVPWTd、LVMI显著高于NLVH组（P均<0.05）,两组E/A比较P>0.05;三组LVEF比较P>0.05。LVH组左心室收缩...     

实时三平面容积/应变率成像评价心肌梗死患者左心房整体及局部功能

目的:应用实时三平面超声心动图（RT-3PE）和实时三平面应变率成像（Triplane-SRI）技术定量评价心肌梗死患者左心房整体及局部功能,探讨左心室功能的损害对左心房功能的影响。方法: A组为31例左心室射血分数（LVEF）≥50%的心肌梗死患者;B组为20例LVEF<50%的心肌梗死患者,C组为30例正常人。组织多普勒测量二尖瓣环收缩期峰值速度（Sa）、舒张早期峰值速度（Ea）和舒张晚期峰值速度（Aa）。脉冲多普勒测量二尖瓣口舒张早期峰值流速（E）、舒张晚期峰值流速（A）。RT-3PE软件获得左心房最大容积（LAVmax）、最小容积（LAVmin）、收缩前容积（LAVpre）、总排空分数（LAVtEF）、被动排空分数（LAVpEF）、主动排空分数（LAVaEF）等参数。Triplane-SRI软件获得左房前壁、侧壁、后壁、下壁和房间隔的心室收缩期、舒张早期和心房收缩期峰值应变率并计算其平均值（MSRS、MSRE和MSRA）。结果: ①与C组比较,A、B两组Sa、Ea及Aa均显著减低（P<0.05）,A组E峰显著减低（P<0.05）,A峰显著增加（P<0.05）,EA。②与C组比较,B组LAVtEF、LAVpEF及LAVaEF均显著减低（均P<0.05）,A组LAVtEF、LAVpEF显著减低（P<0.05）,但LAVaEF减低不显著。③与C组比较,B组各左心房壁及房间隔MSRS、MSRE及MSRA均显著减低（均P<0.05）,A组各左心房壁及房间隔MSRS、MSRE均显著减低（均P<0.05）,但左心房侧壁、后壁及下壁MSRA减低不显著。结论: RT-3PE和Triplane-SRI能从左心房容积和心房肌形变的角度综合评价左心房功能。     

2D-STI在老年高血压性心脏病患者心肌微循环灌注及左心室收缩功能评估中的价值

目的 探讨超声二维斑点追踪(2D-STI)在老年高血压性心脏病(HHD)患者心肌微循环灌注及左心室收缩功能评估中的价值。方法 选取抚州市妇幼保健院2019年7月至2021年5月收治的60例老年HHD患者为观察组,另选取同期就诊的60例老年高血压患者为对照组,对比两组超声心动图参数。心肌声学造影(MCE)参数分析时,将观察组按心肌节段厚度分为两组,观察1组(n=30,心肌节段增厚),观察2组(n=30,心肌节段正常),对比3组MCE参数及心肌节段厚度(MST),分析MCE参数与HHD患者MST的相关性。结果 两组左室射血分数(LVEF)、左心室质量指数(LVMI)水平无显著差异(P>0.05),观察组左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)、晚期峰值血流速度(A)、左心房心肌收缩期平均峰值应变率(mSRs)水平均明显高于对照组,早期峰值血流速度(E)、E/A、左心房心肌舒张早期平均峰值应变率(mSRe)、心房收缩期平均峰值应变率(mSRa)水平均明显低于对照组(均P<0.05)。LVEDV、LVESV、E、A、mSRs、mSRe、mSRa评估老年HHD患...     

The potential clinical role of ultrasonic strain and strain rate imaging in diagnosing acute rejection after heart transplantation.

BACKGROUND: There has been a continued search for a more sensitive noninvasive technique for detecting sub-clinical acute rejection in heart transplant recipients. Ultrasonic deformation imaging (strain/strain rate) is sensitive in detecting sub-clinical abnormalities in regional systolic function and could potentially be sufficiently sensitive to detect changes in deformation induced by graft rejection. AIM: To assess the use of strain (S) and strain rate (SR) imaging as a noninvasive method for monitoring and diagnosing acute rejection in heart transplant recipients. METHODS AND RESULTS: A prospective preliminary study was carried out involving 31 consecutive heart transplant patients who underwent a total of 106 routine follow up endomyocardial biopsy with correlative cardiac ultrasound data. To assess regional longitudinal deformation, ultrasonic S and SR data were acquired from the intraventricular septum, left ventricular (LV) lateral and right ventricular free walls (RVFW). For radial deformation, data were obtained from the LV posterior wall (LVPW). According to the International Society of Heart and Lung Transplantation criteria, 88 biopsies (Group 1) had grade 0 or IA rejection, and 18 biopsies (Group 2) had > or =grade IB rejection. Longitudinal peak systolic S and SR were decreased (p<0.05) in Group 2, compared to Group 1 in the RVFW basal and apical segments and the basal and mid segments of the LV lateral wall. Radial peak systolic S and SR were significantly lower (p<0.001) in Group 2, compared to Group 1. CONCLUSIONS: S/SR imaging might be a good technique and an additional tool for detecting > or =IB grade of acute rejection. The myocardial deformation, as assessed by S/SR imaging could be of clinical value in monitoring and diagnosing acute rejection in heart transplant recipients and could improve patients' management by reducing the number of biopsies performed.     

Effect of obesity on left ventricular structure and myocardial systolic function: assessment by tissue Doppler imaging and strain/strain rate imaging

BACKGROUND: Obesity is associated with heart failure, cardiovascular morbidity, and mortality. A direct effect of weight on left ventricle (LV) structure and myocardial function is not well-established. AIM: The aim of our study is to determine the effect of obesity on LV morphology and systolic function by using LV standard Doppler echocardiographic indices, myocardial Doppler imaging and strain/strain rate imaging indices. METHODS: We studied 33 obese and 34 age, sex-adjusted control subjects who had no other pathological conditions. Standard transthoracic Doppler echocardiographical measurements, reconstructed spectral pulsed wave tissue Doppler velocities, strain and strain rate imaging of six different myocardial regions were obtained. Peak systolic velocity (SR), peak systolic strain (I), peak systolic strain rate (SR) for each region and as a global systolic longitidunal LV function mean of peak systolic strain of six myocardial regions (glsca) were compared. RESULTS: Age, body surface area, blood pressure, and heart rate were comparable between the two groups. Obese subjects had significantly increased LV end-diastolic volume, septal wall thickness, left atrial diameter, and decreased transmitral early to late diastolic velocity ratio. In obese subjects, reconstructed spectral pulsed-wave tissue Doppler analysis showed significantly decreased basal lateral peak systolic (Sm) velocity (6.68 +/- 1.89 vs. 8.08 +/- 2.50, P < 0.05), mid lateral Sm (5.01 +/- 2.17 vs. 6.78 +/- 3.22, P < 0.05). Differences in regional strain rate (mid septal SR, 1.45 +/- 0.23 vs. 1.63 +/- 0.18, P < 0.05), regional strain (basal septum I, 19.13 +/- 3.83 vs. 22.09 +/- 4.60, P < 0.05; mid-septum I, 18.03 +/- 2.91 vs. 20.25 +/- 4.77, P < 0.05; radial I, 27.50 +/- 7.32 vs. 35.53 +/- 9.48, P < 0.05), and global strain (glsca, 19.38 +/- 1.34 vs. 21.24 +/- 2.82, P < 0.05) were identified between obese and the referent subjects. CONCLUSIONS: Obesity is associated with morphologic alterations in left ventricle and left atrium and subclinical changes in left ventricle systolic function which can be detected by strain and strain rate imaging even without overt heart disease.     

Right ventricular strain and strain rate properties in patients with right ventricular myocardial infarction

BACKGROUND: This study was planned to assess strain and strain rate properties of right ventricle in patients with RV myocardial infarction. MATERIAL AND METHOD: Thirty patients with acute inferior myocardial infarction were included in this study. The presence of right ventricular infarction in association with an inferior myocardial infarction was defined by an ST-segment elevation 0.1 mV in lead V4 R. According to this definition, 15 patients had electrocardiographic signs of inferior myocardial infarction without right ventricular infarction (group I), and 15 patients had electrocardiographic signs of inferior myocardial infarction with right ventricular infarction (group II). Echocardiography was performed using a Vivid 5 System (GE Ultrasound; Horten, Norway) and a 2.5-MHz transducer. 2-dimensional color doppler myocardial imaging (CDMI) data for longitudinal function were recorded from the RV free wall using standard apical view. Offline analysis of the myocardial color Doppler data for regional velocity (V), strain rate (Sr), and strain (S) curves was performed using a special software program (EchoPac 6.4 Vingmed, Horten, Norway). They were assessed in basal, middle and apical segments of the RV. The differences between different groups were assessed with the Mann-Whitney U-test. A value of P < 0.05 was considered statistically significant. RESULTS: Systolic tissue velocity, strain, strain rate of basal (4.8 +/- 0.8 cm/s vs 6.5 +/- 1.2 cm/s, -12 +/- 3% vs -24 +/- 5%, 1.28 +/- 0.3/s vs -1.9 +/- 0.4/s; P < 0.001, <0.001, <0.001, respectively) and mid (4.2 +/- 0.5 cm/s vs 5.4 +/- 0.5 cm/s, -16 +/-3% vs -26 +/- 4%, -1.2 +/- 0.3/s vs -2.1 +/- 0.3/s; P < 0.001, <0.001, <0.001, respectively) segments of right ventricle were significantly lower in patients with RV infarction than in patients without RV infarction. There were no differences between groups for apical strain, strain rate, and systolic tissue velocity. CONCLUSION: This study demonstrates that right ventricular strain and strain rate were lower in patients with left ventricular inferior wall myocardial infarction with, compared to without, right ventricular infarction.     

超声斑点追踪技术对系统性红斑狼疮患者局部心肌收缩功能的评价

目的 应用超声斑点追踪技术(STI)评价系统性红斑狼疮(SLE)患者局部心肌收缩功能.方法 ①SLE组36例,健康对照组24名,分别记录并存储每位被检者心尖位左心室3个长轴切面高帧频二维动态图像,应用自动功能成像软件(AFI)检测左心室壁18节段收缩期峰值应变(S),记录并比较各参数测值.②在对照组中随机取20名被检者,双盲条件下,由同一观察者不同时间及2名观察者分别测量每位被检查者心肌收缩期峰值应变值,2组问计量资料比较采用非配对t检验,并利用Pearson相关分析法分析其相关性.结果 对照组左心室各壁S值自基底段向心尖段逐渐增加,心尖段与基底段、中间段差异有统计学意义(P＜0.05),不同室壁对应节段间差异无统计学意义(P＞0.05);同一室壁各节段心肌收缩期峰值应变达峰时间基本一致.SLE组除前间隔和前壁外各室壁S值自基底段向心尖段逐渐增加[(-18.7+4.2)%,(-16.3±9.4)%,(-18.1±10.5)%与(-19.0±9.0)%,(-18.6±7.9)%,(-17.7±1.4)%],心尖段与基底段、中间段差异均无统计学意义(P＞0.05);SLE组各室壁各节段S值明显低于对照组,差异均有统计学意义(P＜0.05);SLE组同一室壁各节段心肌收缩期峰值应变达峰时间一致性差.同一观察者不同时间及2名观察者问对心肌收缩期峰值应变值的测量相关性良好(P＜0.01).结论 STI技术发现SLE患者与健康对照组差异有统计学意义,SLE患者心肌损害表现为左室局部心肌收缩期峰值应变减低.

Abstract：

Objective To assess the vaIue of speckle tracking imaging (STI) in quantifying the regional myocardial strain in systemic lupus erythematosus (SLE) group.Methods ① Sixty subjects were divided into SLE group and normal group.High frame rate two-dimensional images were recorded from the apical two-chamber view,long-axis view and four-chamber view of the left ventricle (LV).Peak systolic strain of each view of 18 segments were measured by automated functional imaging (AFI) software of 2-DSE.All parameters were compared between the two groups.② Twenty cases were randomly taken from the normal group.The same observer at different times and two observers measure the strain of left ventricular respectively.The results of the measurement between the two groups were compared with unpaired t test and its relevance was analyzed using Pearson's correlation analysis.ResultsLeft ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the normal group.There were statistically differences between the apical segments and the basal,middle segments of every left ventricular wall (P＜0.05).The same wall segment time to peak myocardial systolic peak strain was consistent.Left ventricular two-dimensional longitudinal strain gradually increased from the base to apex in the SLE group,except for the anterio-septal and anterior wall [ (-18.7±4.2)％,(-16.3±9.4)％,(-18.1±10.5)％ vs (-19.0±9.0)％,(-18.6±7.9)％,(-17.7±1.4)％ ].There was no statistically significant difference between the apical segments and the basal,middle segments of every left ventricular wall(P＞0.05).All parameters of S were significantly higher in the normal group than those of the SLE group.The difference was statistically signoficant (P＜0.05).The time to peak systolic peak strain of every segments was not consistent.The results from the same observer at different times and peak systolic myocardial strain measurements by the two observers were correlated well(P＜0.01).Conclusion The myocardial function assessment by STI technology in the SLE patients is significantly different from that of the normal control:SLE patients with left ventricular myocardial damage can be manifested as reduced regional myocardial systolic peak strain.     

Relationship between regional and global left ventricular systolic and diastolic function in patients with coronary artery disease assessed by strain rate imaging.

BACKGROUND: The relationship between regional and global left ventricular function has not been evaluated. The present study aimed to assess whether regional myocardial contraction and relaxation reflect global left ventricular systolic and early diastolic function, respectively. METHODS AND RESULTS: The study involved 45 patients with coronary artery disease (CAD). Conventional echocardiography was performed, and segmental peak strain rate (SR) in the systole (S(SR)) and early diastole (E(SR)) were obtained from tissue Doppler imaging in each of 18 segments of the left ventricular myocardium from the apical views. The E(SR) was significantly correlated with S(SR) in all studied segments (r=0.55, p<0.0001). The average values of SR indices in each patient were defined as S(SR) index and E(SR) index, which were derived by dividing the summed value of the S(SR) or E(SR) by the number of respective assessable segments. A significant positive relationship was observed between the S(SR) index and left ventricular ejection fraction (r=0.85, p<0.0001). Also, there was a positive correlation between the E(SR) index and mitral flow E (r=0.68, p<0.0001). CONCLUSIONS: Regional myocardial contraction and relaxation, as assessed by SR imaging, were closely related in patients with CAD. Furthermore, regional myocardial contraction and relaxation are important factors affecting global left ventricular systolic and early diastolic function.     

多普勒组织成像评价肥厚型心肌病左室舒张功能

目的应用多普勒组织成像脉冲技术测量二尖瓣环舒张速度,以评价肥厚型心肌病左室舒张功能.方法对90例肥厚型心肌病患者及50例正常人进行常规超声心电图及多普勒组织成像检查,测量各房室内径,室壁厚度,射血分数及二尖瓣环各点舒张早期峰值速度(Ea)、舒张晚期峰值速度(Aa).两组指标比较采用成组t检验.结果肥厚型心肌病患者室间隔厚度(25.5±6.6)mm,左室后壁厚度(9.9±2.3)mm,左室内径(42.9±5.9)mm,左房内径(39.9±4.7)mm,LVEF(71.9±4.3)%,二尖瓣血流E/A为1.42±0.7.肥厚型心肌病患者Ea较正常人减低.Aa无明显差异.结论肥厚型心肌病左室长轴主动松弛功能较正常人减低.     

Myocardial dysfunction in Takotsubo syndrome: More than meets the eye?

IntroductionTakotsubo syndrome (TTS) is characterized by transient left ventricular (LV) dysfunction, typically mimicking an anterior wall myocardial infarction (MI), without obstructive coronary artery disease. In the few published reports assessing myocardial deformation in TTS and MI, no consistent differences have been described between the two entities. We sought to characterize global and regional function in TTS and to compare it with a population with MI.MethodsClinical data, including echocardiography, were gathered from 17 TTS patients and 20 anterior wall ST-segment elevation myocardial infarction (STEMI) controls. Peak systolic longitudinal strain was determined for each LV segment using speckle tracking imaging, and global and mean apical, midventricular and basal longitudinal strain were calculated from these.ResultsBoth TTS and STEMI patients presented significant LV systolic dysfunction, and there were no significant differences in ejection fraction or global longitudinal strain. Regional longitudinal strain was more severely impaired in basal inferolateral and mid anterolateral segments in the TTS group and in apical anteroseptal segments in the STEMI group. Mean longitudinal strain was worse in the basal segments of TTS patients (-9.8±2.9 vs. -12.4±4.1%, p=0.010), with no significant differences in mid and apical segments. The basal/apical ratio was significantly lower in this group as well (1.51±0.86 vs. 2.94±1.88, p=0.006).ConclusionsWhile both TTS and STEMI feature significantly impaired global systolic function, we found a regional pattern of worse basal longitudinal strain and a lower basal/apical ratio in the former. These suggest generalized myocardial impairment in TTS, providing new clues about its pathophysiology and possible specific echocardiographic changes.     

速度向量成像技术评价心血管疾病高危病人左心室收缩功能的临床研究

目的应用速度向量成像(VVI)技术评价心血管疾病高危病人左心室收缩功能,并分析其与心血管疾病高危因素的关系。方法选取85例心血管疾病高危病人为高危组,同期健康体检者50名为对照组,常规超声心动图获取左房收缩末期内径(LAESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVS)、左室后壁厚度(LVPW)及左室射血分数(LVEF)。并采集心尖四腔、三腔、二腔长轴二维图像,测量各节段及整体纵向收缩峰值应变(GLS),分析左心室GLS与三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及收缩压、舒张压的相关性。结果高危组各亚组LVEF、LVEDD、LAESD、IVS、LVPW值与对照组比较,差异均无统计学意义(P>0.05);高危组左心室GLS(21.83±1.80)%,小于对照组的(23.00±1.97)%,差异有统计学意义(P<0.05)。相关分析显示,左心室整体平均纵向应变值与TG、LDL-C及收缩压、舒张压均无明显相关性(r=-0.148,P=0.086;r=-0.168,P=0.052;r=-0.098,P=0.260;r=-0.075,P=0.386)。结论VVI可通过心肌纵向应变评价左室心肌的收缩功能,发现心血管疾病高危病人的亚临床左心收缩力异常。     

应变成像定量评价冠心病病人局部心肌收缩功能

目的 应用应变成像技术定量评价冠心病局部心肌收缩能.方法 应用应变成像对冠心病病人53例和正常人42名左心室前间隔与后壁径向、各室壁节段纵向收缩期峰值应变进行测定,并以冠状动脉造影结果为标准进行对比分析.结果 冠心病病人缺血心肌的收缩期峰值应变表现为明显减低、消失,甚至倒置.冠心病组各室壁缺血节段收缩期径向、纵向峰值应变测值均较对照组相应节段明显减低.结论 冠心病缺血心肌收缩期峰值应变明显减低,应变成像技术是临床无创、定量评价冠心病局部心肌功能的新方法.     

Assessment of characteristics of myocardial deformation in healthy subjects of various age groups by the X-STRAIN echocardiography

Aim of the study was to master XStrain software and to obtain values of left ventricular (LV) myocardial velocity, longitudinal, circumferential, radial strain, and strain rate in a population of healthy subjects from various age groups. Sixty healthy volunteers were divided into 2 groups: aged 19-30 years (n = 35, mean age 24.6 +/- 3.1 years) and 30-58 years (n = 25, mean age 43.2 +/- 9.1 years). Values of all types of myocardial strain and circumferential strain rate did not differ substantially between groups at all LV levels: basal, median, and apical. Radial strain rate in the studied groups diminished from basal to apical LV segments. Longitudinal strain rate differed between LV sections in subjects older than 30 years. Myocardial velocity decreased from basal to apical myocardial segments.