二维斑点追踪成像技术在生理性和病理性心肌肥厚鉴别中的作用

运用二维斑点追踪成像（2D—STI）技术分析肥厚型心肌病患者16例、运动员18例、健康对照组20例三组左心室心肌应变，心尖四腔观切面获取整体长轴应变（GLS）和局部心肌峰值收缩应变（PSS）。结果显示，与运动员组和对照组比较，肥厚型心肌病组GLS减低-（8．0±3．6）％，P〈0．01]；运动员组与正常对照组GLS比较差异无统计学意义（P〉0．05）。但正常对照组间隔基底段、中间段、侧壁中间段长轴应变，间隔基底段、中间段、心尖段、侧壁基底段、中间段局部心肌节段PSS显著高于运动员组。以左心室GLS小于-10％为截断值诊断病理性左心室肥厚的敏感性、特异性分别为84．0％、94．0％。提示STI技术能定量评价左室整体与局部收缩功能，有助于区分左心空生理性肥厚与病理性肥厚。

Evaluation the global and regional myocardial function of patients with hypertrophic cardiomyopathy by two-dimensional speckle tracking imaging

Two-dimensional speckle tracking imaging(2D-STI)can accurately evaluate myocardial strain with non-angle dependent and good reproducibility. In this study, 16 patients with hypertrophic cardiomyopathy (HCM), 18 athletes and 20 normal subjects underwent 2D-STI examination. The global longitudinal strain (GLS) and regional peak systolic strain (PSS) were assessed by 2D-STI in the apical four-chamber-view. Compared to athletes and normal subjects, GLS in patients with HCM was significantly reduced GLS: -(8. 0±3.6)% , P ＜ 0. 01]. There was no significant difference in GLS between athletes and the controls, but GLS in basal or middle segments of interventricular septum and middle segments of lateral wall; PSS in basal, middle or apical segments of interventricular septum and basal or middle segments of lateral wall of the normal controls were significantly higher than those of the athletes. A cut-off value of less than -10% in GLS for diagnosis of pathologic hypertrophy resulted in a sensitivity of 84. 0% and a specificity of 94. 0%. The results suggest that 2D-STI can quantify global and regional myocardial function and may be used for the differentiation between physiological and pathologic LVH.