斑点追踪显像技术评价原发性高血压病患者早期左心室旋转及扭转功能

目的探讨斑点追踪显像(speckle tracking imaging,STI)评价原发性高血压(EH)患者早期左心室旋转和扭转运动改变的价值。方法对35例左心房、左心室正常构型的EH患者(高血压组)和35例健康者(对照组),经胸采集左心室短轴心尖水平和心底水平的二维图像,计算心底水平旋转角度峰值(MV-Prot)、心尖水平旋转角度峰值(AP-Prot)、扭转角度峰值(Ptw)。结果两组受检者心尖部旋转角度均显著大于心底部旋转角度,差异均有统计学意义(P<0.01);但两组达峰时间比较,差异无统计学意义(P>0.05);高血压组患者心尖部旋转角度显著大于对照组,差异有统计学意义(P<0.05)。结论 EH患者早期左室整体心肌扭转运动主要表现为逆时针方向扭转,扭转运动增强。     

二维斑点追踪成像评价急性心肌梗死患者左室扭转及解旋的研究

目的 采用超声二维斑点追踪成像(STI)评价急性心肌梗死(AMI)患者左室扭转及解旋变化.方法 45例AMI患者(AMI组)及48例正常人(NOR组),采用STI测量左室基底及心尖段心肌旋转及解旋角度峰值(Ptw base,Ptw apex,UntwR base,UntwR apex)、左室扭转角度峰值(Ptw)、左室解旋率峰值(Untw R)、左室扭转达峰时间(TPtw)和左室解旋迭峰时间(TPUR).结果 AMI组Ptw base、Ptw apex、Ptw、UntwR base、UntwR apex和UntwR减低(P<0.01).AMI组TPtw早于NOR组(P<0.01).LVEF与Ptw apex、Ptw相关性良好(P<0.001).结论 STI可通过检测心肌扭转评价AMI患者左室收缩及舒张功能,为临床提供一种可靠的新方法,具有广泛的应用前景.     

超声二维斑点追踪显像技术对原发性高血压患者不同心室构型扭转运动的评价研究

目的 应用二维斑点追踪显像技术对原发性高血压患者不同左心室构型扭转和解旋运动特点进行评价,探讨心室构型不同对左心室扭转运动造成的影响.方法 选择健康体检者46例和原发性高血压患者121例,根据Ganau's国际分型法,将高血压患者分成4组:左心室正常构型组(LVN组)、左心室向心性重构组(LVCR组)、左心室向心性肥厚组(LVCH组)和左心室离心性肥厚组(LVEH组).取心率稳定的连续3个心动周期的左室基底部和心尖部短轴切面在GE E9超声诊断仪上储存,导人工作站分析软件对各组的左室扭转和解旋运动参数进行脱机分析,计算出扭转角度峰值(Ptw)、收缩末期扭转角度(AVCtw)、等容舒张末期扭转角度(MVOtw)、等容解旋比例(UntwR)、解旋速度峰值(PUV)、解旋速度峰值达峰时间(TPUV)、扭转速度峰值(PTV)和扭转速度峰值达峰时间(TPTV).结果 各组常规超声心动图测量值(LVEDd、LVESd、IVSEDT、LVPWEDT、LVEDV、LVESV、LVEF、IVRT和E/A)比较,差异均有统计学意义(P＜0.05);LVCH组和LVEH组Ptw值增强,扭转角度(AVCtw和MVOtw)明显增加(P＜0.05),解旋时间(PUV和TPUV)延长(P＜0.05),高血压各组UntwR值较对照组减低,与测量左室舒张功能的E/A具有较好的相关性(R2 =0.1699),高血压各组的PTV和TPTV值与对照组相比,差异无统计学意义(P＞0.05);高血压患者左室旋转速度-时间曲线和旋转角度-时间曲线与对照组相比,形态和走形趋势基本一致.结论 斑点追踪技术能对高血压不同心室构型患者左室扭转和解旋运动各项参数进行测量,可以从心肌力学角度为临床高血压病的诊断和治疗提供技术支持.     

超声斑点追踪显像技术评价扩张型心肌病左室扭转特点

目的应用超声斑点追踪显像技术（STI）探讨扩张型心肌病患者（DCM）左室旋转（LVrot）和左室扭转（LVtw）运动特点及左室运动同步性,分析其与常规左室收缩功能参数的关系。方法选择24例DCM患者及与之年龄匹配的24例正常人为研究对象,经胸采集标准短轴左室心尖位、心底位的图像并存储,运用EchoPAC超声工作站进行脱机分析。计算左室心尖位旋转角度、心底位旋转角度、左室扭转峰值及相应达峰时间。结果 DCM患者扭转运动主要表现为心底位顺时针旋转和心尖位逆时针旋转,心脏整体表现为心动周期内逆时针方向为主的扭转运动,正常人也主要表现为心底位顺时针旋转和心尖位逆时针旋转及心脏整体逆时针方向为主的扭转运动。但DCM患者左室扭转峰值[（4.62±1.55）°/（13.85±2.77）°,P〈0.001]显著减低。DCM患者左室扭转峰值（peak tw ist,Ptw）与左室射血分数（LVEF）正相关（r=0.534,P〈0.05）。DCM患者心尖位和心底位旋转角度达峰时间不一致,差异有统计学意义（P〈0.05）。结论 DCM在短轴方向表现为左室旋转和扭转运动减低及整体运动不同步的特点。Ptw减低显示左室收缩功能减低,Ptw与常规左室收缩功能参数LVEF正相关。     

斑点追踪成像评价无心肌肥厚高血压病人左心室功能

目的 应用斑点追踪成像技术（STI）评价无心肌肥厚的原发性高血压病人早期左心室心肌的功能。方法 选取左心室充盈正常的高血压病人40例（Ⅱ组）、左心室松弛性减低的高血压病人40例（Ⅲ组）、健康对照者30例（对照组）、应用STI分别测量各组左心室长轴切面、心尖四腔心切面、两腔心切面整体心肌和心内膜下心肌二尖瓣水平、乳头肌水平、心尖水平收缩期长轴应变,通过左心室短轴心底水平和心尖水平分别计算扭转角度峰值（Ptw）、收缩末期扭转角度（AVCtw）、等容舒张末期扭转角度（MVOtw）、扭转速度达峰时间（PTV）、解旋速度峰值（PUV）、等容解扭转率（UntwR）、解旋减半时间（UHT）等左心室扭转-解旋参数。结果 与对照组比较,Ⅱ组基底段、中间段、心尖段心内膜下心肌收缩期峰值应变减低,Ptw、AVCtw、MVOtw、PTV、PUV增加,UntwR减低,UHT延长,差异均有显著性（F=3.34-23.75,q=1.69-13.51,P〈0.05）;Ⅲ组基底段、中间段、心尖段的心内膜下心肌收缩期峰值应变减低,差异有显著性（F=9.13-11.91,q=2.94-3.64,P〈0.01）。Ⅲ组与Ⅱ组比较,基底段、中间段、心尖段的整体心肌收缩期峰值应变减低,UntwR减低,差异有显著意义（q=3.12-3.59,P〈0.05）。结论 STI可用于评价原发性高血压病人左心室心肌功能的早期受损情况。     

超声斑点追踪显像技术评价正常人左室扭转运动

目的应用二维超声斑点追踪显像技术（STI）探讨正常人左室旋转（LVrot）和左室扭转（LVtw）运动特点,分析其与常规左室收缩功能参数之间的关系及年龄、心率等生理因素对其影响,评价左室运动同步性。方法50例健康志愿者为研究对象,经胸采集标准短轴左室心尖位、心底位的图像并存储,运用EchoPAC超声工作站进行脱机分析。计算左室心尖位旋转角度、心底位旋转角度、左室扭转峰值及相应达峰时间。结果（1）正常人扭转运动主要表现为心底位顺时针旋转和心尖位逆时针旋转,心脏整体表现为心动周期内逆时针方向为主的扭转运动。（2）正常人左室射血分数（LVEF）、短轴缩短率（FS）与左室扭转峰值（peak tw ist,Ptw）呈正相关（r=0.468和0.456,P均〈0.05）。（3）年龄与Ptw呈正相关（β=0.320,P〈0.05）,其中Ⅱ组Ptw（14.55±3.94）°高于Ⅰ组Ptw（12.52±4.63）°（P〈0.05）。心率、、性别、身高、体重与Ptw无相关性（P〉0.05）。（4）心尖位和心底位旋转角度达峰时间差异无统计学意义（P〉0.05）。结论STI技术可无创评估正常人左室旋转和扭转运动特点。常规左室收缩功能参数LVEF、FS与Ptw正相关。临床应用扭转参数评价左室收缩功能时应考虑年龄因素的影响。左室心尖位和心底位旋转角度达峰时间可作为评价左室运动同步性指标之一。     

二维斑点追踪评价充血性心力衰竭患者左心室扭转与收缩同步性的关系

目的 采用超声二维斑点追踪(STE)检测左心室扭转参数,并探讨其与左心室收缩同步性的关系.方法 STE测量48例ORS时限>120 ms的充血性心力衰竭(CHF)患者和40例正常人左心室基底和心尖峰值旋转角度(Rot-Ba和Rot-Ap)及达峰时间(T-Ba和T-Ap)、基底和心尖达峰时间差(Ba-Ap rot delay)、左心室峰值扭转角度(Ptw)和达峰时间(TPtw)、主动脉瓣关闭时扭转角度(AVCtw)以及达Ptw和AVCtw的时间差(AVC-P twist delay),同时测量左心室径向和纵向收缩同步性(TR-AS-POST和TL-SD).两组进行比较.结果 CHF患者左心室Rot-Ba、Rot-Ap、Ptw和AVCtw均减低,Ba-Ap rot delay和AVC-P twist delay均延长.相关分析显示Ptw和AVCtw与左室射血分数和TR-AS-POST显著相关,且Ba-Ap rot delay是Ptw的独立影响因素.结论 宽QRS的CHF患者左心室扭转角度减低,且与径向同步性密切相关.STE能够准确评价左心室纵向、径向和扭转运动同步性.     

斑点追踪成像评价原发性高血压病人左心室扭转及解旋功能

目的应用斑点追踪成像检测原发性高血压病人左心室扭转及解旋运动的变化,探讨其临床意义。方法选取原发性高血压病人61例,其中室间隔肥厚组28例,非室间隔肥厚组33例,另选健康志愿者30例为正常对照组。应用斑点追踪成像计算左心室峰值扭转角度(Ptw)、收缩期末扭转角度(AVCtw)、等容舒张期末扭转角度(MVOtw)和解旋率(UntwR)。结果与正常对照组相比,Ptw、AVCtw、MVOtw在室间隔肥厚组及非室间隔肥厚组均增大(F=14.86～16.70,q=5.69～32.05,P<0.05);与正常对照组及非室间隔肥厚组相比,室间隔肥厚组的UntwR减小(F=18.55,q=6.53、18.90,P<0.05)。结论原发性高血压病人左心室扭转运动增大,解扭转运动在高血压室间隔肥厚病人减低,斑点追踪成像为高血压病人心肌运动的评价提供了一个新途径。     

二维斑点追踪显像技术评价尿毒症高血压患者左室功能的临床应用

目的:通过二维斑点追踪显像技术(2D-STI)定量评价尿毒症高血压和原发性高血压患者左室收缩及舒张功能,并进行对比研究。方法:对30例正常人(A组),35例原发性高血压(B组)和60例尿毒症高血压患者(包括射血分数正常的C1组32例和射血分数减低的C2组28例)采集左室短轴基底水平和心尖水平图像进行二维斑点追踪分析,可得出左室基底部旋转角度峰值(Prot-B)、心尖部旋转角度峰值(Prot-A)、整体扭转角度峰值(PtwAll)及达峰时间(T-Ptw)、收缩末期扭转角度(AVCtw)、解旋率(UntwR)和解旋减半时间(HTU)。并分析扭转和解旋参数与常规超声指标之间的相关性。结果:1扭转参数的比较,原发性高血压组扭转增强(Prot-B、Prot-A、Ptw-All、AVCtw增加,T-Ptw缩短,P<0.05);尿毒症高血压C1组扭转减弱(Prot-B、Prot-A、Ptw-All、AVCtw降低,T-Ptw延长,P<0.05);C2组减弱更显著,差异均有统计学意义(P<0.05)。2解旋参数的比较,UntwR和HTU在正常对照组、原发性高血压组、尿毒症高血压C1组、尿毒症高血压C2组依次降低,差异有统计学意义(P<0.05)。3整体扭转角度峰值Prot-All与LVEF呈正相关,与LVEDD呈负相关;解旋率UntwR与LAD相关性较强,r=-0.663,P<0.05。结论:原发性高血压患者左室扭转运动增强,解旋能力降低,尿毒症高血压左室扭转运动减低,解旋功能更低。2D-STI技术可早期识别尿毒症高血压和原发性高血压心肌力学改变,为临床提供重要信息。     

超声二维斑点追踪显像技术评价正常人左室心肌扭转运动与心动周期时相关系的初步研究

目的:探讨斑点追踪显像技术(STI)评价正常人心肌旋转及左室扭转与心动周期时相关系的价值.方法:健康志愿者32例,分别获取左室心尖和二尖瓣短轴观图像;测量各短轴图像在标化时间点处的旋转角度,并依此计算在各标化点处的左室扭转角度;观察各短轴观旋转值及左室扭转值随时间变化关系;测量收缩期峰值旋转及左室扭转值和相应达峰时间.结果:正常人左室扭转运动主要表现为:等容收缩期心底部短暂的逆时针旋转和心尖部顺时针旋转;射血期心底部顺时针旋转和心尖部逆时针旋转,心脏整体表现为逆时针旋转,舒张期逐渐恢复.结论:斑点追踪显像技术可以评价左室旋转/扭转及与心动周期时相的关系.     

Assessment of Age-related Changes in Left Ventricular Twist by Two-dimensional Ultrasound Speckle Tracking Imaging

To assess the normal value of left ventricular twist （LVtw） and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging （STI）, 121 healthy volunteers were divided into three age groups： a youth group （19-45 y old）, a middle-age group （46-64 y old ） and an old-age group （≥65 y old）. Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation （LVrot） and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist （Ptw）, twist at aortic valve closure （AVCtw）, twist at mitral valve opening （MVOtw）, untwisting rate （UntwR）, half time of untwisting （HTU）, peak twist velocity （PTV）, time to peak twist velocity （TPTV）, peak untwisting velocity （PUV）, time to peak untwisting velocity （TPUV） were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock- wise rotation at the apex （as seen from the apex）. The LVtw velocity showed a systolic counterclockwise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole （96%±4.2% of systole）. With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly （P〈0.05） and UntwR decreased significantly （P〈0.05）. However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups （P〉0.05）. It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.     

Assessment of age-related changes in left ventricular twist by two-dimensional ultrasound speckle tracking imaging

Summary To assess the normal value of left ventricular twist (LVtw) and examine the changes with normal aging by 2-dimensional ultrasound speckle-tracking imaging (STI), 121 healthy volunteers were divided into three age groups: a youth group (19–45 y old), a middle-age group (46–64 y old) and an old-age group (≥65 y old). Basal and apical short-axis images of left ventricular were acquired to analyse LV rotation (LVrot) and LVrot velocity. LVtw and LVtw velocity was defined as apical LVrot and LVrot velocity relative to the base. Peak twist (Ptw), twist at aortic valve closure (AVCtw), twist at mitral valve opening (MVOtw), untwisting rate (UntwR), half time of untwisting (HTU), peak twist velocity (PTV), time to peak twist velocity (TPTV), peak untwisting velocity (PUV), time to peak untwisting velocity (TPUV) were separately measured. The results showed that the normal LV performs a wringing motion with a clockwise rotation at the base and a counterclock-wise rotation at the apex (as seen from the apex). The LVtw velocity showed a systolic counterclock-wise twist followed by a diastolic clockwise twist. Peak twist develops near the end of systole (96%±4.2% of systole). With aging, Ptw, AVCtw, MVOtw, HTU and PUV increased significantly (P<0.05) and UntwR decreased significantly (P<0.05). However, no significant differences in TPUV, PTV and TPTV were noted among the 3 groups (P>0.05). It is concluded that LV twist can be measured non-invasively by 2-dimensional ultrasound STI imaging. The age-related changes of LVtw should be fully taken into consideration in the assessment of LV function.     

Assessment of Left Ventricular Global Twist in Essential Hypertensive Heart by Speckle Tracking Imaging

The left ventricular twist was evaluated by 2-dimensional ultrasound speckle-tracking imaging （STI） in 50 patients with hypertension with normal geometric left ventricle （LV） and 45 normal subjects as control group. The mean value of LV rotation was obtained at each plane Using STI. LV twist and twist velocity were defined as apical rotation/rotation rate relative to the base respectively. To adjust the intersubject differences in heart rates, the time sequence were normalized. The results showed that peak twist developed near the end of systole. Peak LV twist was significantly higher in patients with hypertension than normal controls （P〈0.001）. The diastolic untwisting mainly occurred in early diastole （=38%）. Compared with normal controls, untwisting rate （Untw R） in patients with hypertension was significantly reduced （P〈0.001）, and untwisting half-time （UHT） was significantly delayed （P〈0.05）. This study demonstrated that STI has a potential ability to evaluate the early change of heart function in patients with hypertension by measuring the twist of LV.     

二维斑点追踪检测的左心室扭转预测心脏再同步化治疗的短期疗效

 目的探讨超声二维斑点追踪（STE）检测的左心室扭转参数预测心脏再同步化治疗（CRT）短期疗效的价值。方法接受CRT治疗的心衰患者34例,在术前3 d及术后1个月采用STE检测左心室基底和心尖峰值旋转角度（Rot-Ba 和Rot-Ap）、基底和心尖达峰值旋转角度时间（T-Ba 和T-Ap）、基底和心尖达峰时间差（Ba-Ap Rot Delay）、左心室峰值扭转角度（Ptw）和达峰时间（TPtw）、左心室标化峰值扭转角度（Ptor）。将术后左室收缩末容积（LVESV）减小率△LVESV≥15%定义为CRT短期治疗有效。结果21 例（61.8%）患者为CRT 短期治疗有效组（R 组）。术前R 组Rot-Ba、Rot-Ap、Ptw 和Ptor 大于无效组（NR 组）,Ba-Ap
Rot Delay 短于NR 组,其余参数无差异。术后与NR组比较,R 组的Rot-Ba、Rot-Ap、Ptw 和Ptor 增大,Ba-Ap Rot Delay 缩短。Rot-Ap、Ptw 和Ptor 是△LVESV≥15%的独立影响因素,Ptw跃2.2毅预测CRT 短期治疗有效的敏感性和特异性分别为78%和74%。结论STE 检测的左心室扭转参数可准确预测CRT 短期疗效。     

Evaluation of Left Ventricular Rotation and Twist Using Speckle Tracking Imaging in Patients with Atrial Septal Defect

Speckle tracking imaging （STI） was employed to investigate the effect of right ventricular （RV） volume and pressure overload on left ventricular （LV） rotation and twist in 35 patients with atrial septal defect （ASD）, 18 of which with pulmonary hypertension, and 21 healthy subjects serving as controls. The peak rotations of 6 segments at the basal and apical short-axises and the average peak rotation and interval time of the 6 segments in the opposite direction during early systolic phase were measured respectively. LV twist versus time profile was drawn and the peak twist and time to peak twist were calculated. LV ejection fraction （EF） was measured by Biplane Simpson. Compared to ASD patients without pulmonary hypertension and healthy subjects, the peak rotations of posterior, inferior and postsept walls at the basal level were lower （P〈0.05）, and the average counterclockwise peak rotation of 6 segments at the basal level during early systolic phase was higher （P〈0.05）, and the average interval time was delayed （P〈0.05）. LV peak twist was also lower （P〈0.05）, and had a significant negative correlation with pulmonary arterial systolic pressure （r=-0.57, P=0.001）. No significant differences were found in LVEF among the three groups. It was suggested that although RV volume overload due to ASD has no significant effects on LV rotation and twist, LV peak twist is lower in ASD patients with pulmonary hypertension. Thus LV twist may serve as a new indicator of the presence of pulmonary hypertension in ASD patients.     

Ultrasound Speckle Tracking Imaging Contributes to Early Diagnosis of Impaired Left Ventricular Systolic Function in Patients with Type 2 Diabetes Mellitus

To investigate the value of ultrasound speckle tracking imaging （STI） in the assessment of the short-axis and long-axis systolic function of the left ventricle （LV） in patients with type 2 diabetes mellitus （DM）, 100 subjects with normal ejection fraction were studied, including 41 patients with DM only （DM group）, 22 patients with both DM and left ventricular hypertrophy （DH group）, and 37 healthy subjects （control group）. Left ventricle systolic function in the long axis defined as longitudinal strain, and that in the short axis defined as radial strain, apical and basal LV rotations, and LV twist were assessed respectively. The results showed that average peak strain in the long axis at basal, middle and apical levels, and global peak strain were significantly decreased in the patient groups when compared with the control group （P〈0.001 for each）. The parameters in DH group were significantly lower than those in DM group （P〈0.01 for each）. There were no significant differences in average radial peak strain in the short axis at different levels, and global peak strain among the three groups （P〉0.05）. Apical and basal LV rotations, and LV twist were greater in the patient groups than in the control group （P〈0.01 for each）. Basal LV rotation and LV twist were greater in DH group than those in DM group （P〈0.01）. It was concluded that STI may be used to identify early abnormalities in patients with type 2 DM that have normal left ventricular systolic function.     

超声二维斑点追踪显像技术评价2型糖尿病患者左心室功能的临床价值

目的：应用超声二维斑点追踪显像（STI）技术探讨2型糖尿病患者左心室心肌扭转运动的特点。方法：选取2012年5月至2013年9月在浙江医院就诊的93例2型糖尿病患者,根据左心室射血分数（LVEF）分为心功能正常组（LVEF≥0.50,46例）和心功能衰竭组（LVEF<0.50,47例）。另设正常对照组（n=46）。应用STI定量分析三组受检者的左心室扭转情况,分析左心室扭转角度峰值（Peaktw）、主动脉瓣关闭时间点扭转角度（AVCtw）、二尖瓣开放时间点扭转角度（MVOtw）等指标与常规超声心动图检测指标LVEF、Tei指数、二尖瓣口E峰值/二尖瓣口A峰值(E/A)比值、二尖瓣口血流频谱E峰值/组织多普勒二尖瓣环运动e峰值(E/e)比值间的相关性;并进行一致性检验以评价STI的稳定性及可靠性。 结果：心功能正常组的Peaktw、AVCtw、MVOtw均高于正常对照组（均P<0.05）,心功能衰竭组Peaktw、AVCtw、MVOtw均低于心功能正常组和正常对照组（均P<0.05）。糖尿病患者的Peaktw、AVCtw、MVOtw与LVEF呈正相关（r=0.968、0.966、0.938,均P<0.05）,与Tei指数呈负相关（r=-0. 834、－0.811、－0.797,均P<0.05）,与E/A比值呈正相关（r=0.798、0.790、0.788,均P<0.05）,与E/e比值呈负相关（r=－0.823、－0.805、－0.771,均P<0.05）。一致性检验显示Peaktw在检测者间的R=0.957, 偏倚为-0.1 ,95%一致性界限为-2.8～2.7;在检测者内的R=0.964,偏倚为-0.2, 95%一致性界限为-2.7 ～ 2.2。结论：STI能够早期识别2型糖尿病患者的心功能异常变化,检测技术具有较高的稳定性及可靠性。     

应用超声斑点追踪技术评价室间隔缺损封堵前后心脏扭转运动的变化

目的:运用二维超声斑点追踪技术评价经皮室间隔封堵术前后患者心脏扭转运动的变化.方法:检测18例室间隔缺损患者封堵术前、术后第3天、术后1个月、术后3个月的常规心脏二维多普勒超声参数,并运用二维斑点追踪技术对患者的左心室旋转及扭转运动进行分析,以探讨室间隔缺损封堵术对其心脏扭转运动的影响.结果:封堵术后第3天,舒张期末左室内径(LVEDd)、左室舒张末容积(LVEDV)较术前减低较明显,左心室的基底部、心尖部的旋转角度及整体的扭转运动的角度较术前稍有减低.术后1个月、术后3个月,LVEDd、LVEDV较术前仍有降低,但降低的程度有减小的趋势;而左心室的基底部、心尖部的旋转角度及整体的扭转运动的角度仍有降低,降低的程度以术后1个月最明显,以后降低程度减小.患者封堵术前、术后第3天、术后1个月、术后3个月的LVEF稍有改变,但差异尤统计学意义.无论是封堵术前、术后第3天、术后1个月、还是术后3个月有,病人的左心室的基底部、心尖部的旋转角度峰值及整体的扭转运动的角度峰值均和LVEF呈线性相关,且以左室整体的扭转运动的角度峰值和LVEF的相关性最好.结论:经皮室间隔缺损封堵术通过逆转左室的重构而改善左室的扭转运动,且左室整体的扭转运动与LVEF的相关性最好.