二维斑点追踪成像评价室间隔缺损患儿左室整体收缩功能

目的探讨应用二维斑点追踪成像(2D-STI)评价室间隔缺损(VSD)患儿左室整体收缩功能的价值。方法单纯VSD患儿42例,按缺损大小与主动脉瓣环比值分为小VSD组、中VSD组、大VSD组;30例体检健康儿童为对照组。超声心动图常规测量左房收缩末期内径(LAD)、左室舒张末期内径(LVEDD)、左室舒张末期容积(LVEDV)、左室收缩末期容积(LVESV)及左室射血分数(LVEF),计算左房容积。2D-STI测量左室整体纵向峰值应变(GLPS)、收缩期峰值应变率(GLSRS),左室整体径向峰值应变(GRPS)、收缩期峰值应变率(GRSRS)及左室整体圆周峰值应变(GCPS)、收缩期峰值应变率(GCSRS)。结果大VSD组和中VSD组的LAD、LAV、LVEDD、LVEDV、LVESV较小VSD组和对照组均增大(P0.05),大VSD组LAD、LAV、LVEDD、LVEDV、LVESV较中VSD组均增大(P0.05)。与对照组和小VSD组的GLPS、GRPS、GCPS、GLSRS、GRSRS、GCSRS比较,中VSD组均增大(P0.05),大VSD组均减小(P0.05);中VSD组GLPS、GRPS、GCPS、GLSRS、GRSRS、GCSRS亦大于大VSD组(P0.05)。结论中度以上VSD影响左室整体收缩功能。2D-STI的应变、应变率对VSD患儿左室整体收缩功能的评价有重要意义。

Evaluation on global left ventricular systolic function of children with ventricular septal defect by two-dimensional speckle tracking imaging

Objective To explore the value of two-dimensional speckle tracking imaging （2D-STI） in evaluating the global left ventricular systolic function of children with ventricular septal defect. Methods Forty-two children with simple VSD were divided into small, moderate and large VSD group according to the ratio of VSD size to aortic annulus diameter. And 30 healthy children were enrolled as control group. The left atrial systolic diameter （LAD）, left ventricular end-diastolic diameter （LVEDD）, left ventricular end-diastolic volume （LVEDV）, left ventricular end systolic volume （LVESV） and left ventricular ejection fraction （LVEF） were routinely measured by echocardiograph. LA Volume （LAV） was calculated. Global Left ventricular longitudinal peak strain （GLPS）, global longitudinal systolic strain rate（GLSRS）, radial peak strain （GRPS）, radial systolic strain rate （GRSRS）, circumferential peak strain （GCPS）and circumferential systolic strain rate （GCSRS）were measured by 2D-STI. Results Compared with those in small VSD group and control group, LAD、LAV、LVEDD、LVEDV、LVESV were significantly increased in large VSD group and moderate VSD group （P〈0.05）. Compared with those in moderate VSD group , LAD、LAV、LVEDD、LVEDV、LVESV were significantly increased in large VSD group （P〈0.05）. Compared with those in control group and small VSD group, GLPS、GRPS、GCPS、GLSRS、GRSRS、GCSRS were significantly increased in moderate VSD group and were significantly decreased in large VSD group （P〈0.05）. GLPS、GRPS、GCPS、GLSRS、GRSRS、GCSRS in moderate VSD group were also greater than those in large VSD group （P〈0.05）. Conclusion The moderate or above VSD affect global left ventricular systolic function. Strain and strain rate by 2D-STI is of great significance to evaluate global left ventricular systolic function of children with VSD.