二维斑点追踪成像技术评价扩张型心肌病患者左心室心肌纵向收缩功能

目的评价二维斑点追踪成像技术(2D-STI)在扩张型心肌病(dilated cardiomyopathy,DCM)患者的左心室心肌纵向收缩功能应用价值。方法对39例DCM患者和35例正常对照组行常规超声心动图检查得到左心房内径(LAD)、左心室射血分数(LVEF)、过二尖瓣口舒张早期血流速度(Ve)及舒张晚期血流速度(Va);应用2D-STI技术测量DCM患者和正常对照组收缩期纵向峰速度、峰值应变及峰值应变率。结果 DCM患者的LAD、LVESV及LVEDV均明显大于正常对照组(P<0.01),而LVEF明显低于正常对照组(P<0.01),DCM患者与正常对照组在Ve/Va无明显统计学差异(P>0.05);DCM患者左心室各室壁基底段、中间段收缩期纵向峰速度低于正常对照组(P<0.05),心尖段的后壁、下壁及侧壁收缩期纵向峰速度低于正常对照组(P<0.05),前壁及室间隔与正常对照组无明显差异(P>0.05);左心室各室壁收缩期纵向峰值应变及峰值应变率均明显低于正常对照组(P<0.01);DCM患者和正常对照组,从心底往心尖方向观察,收缩期纵向峰速度呈递减趋势。结论 2D-STI技术能准确、全面的分析左心室局部心肌长轴运动的峰速度、峰值应变及峰值应变率,对评价DCM患者的左心室局部心肌纵向收缩功能变化具有重要价值。

Assessment of the Left Ventricular Systolic Function in Dilated Cardiomyopathy Patients by Two-dimensional Speckle Tracking Imaging(2D-STI)

Objective To assess the left ventricular systolic function in patients with dilated cardiomyopathy(DCM).Methods 35 healthy subjects and 39 dilated cardiomyopathy patients underwent conventional echocardiography examination.Left atrial(LA) diameter were measured by M-mode echocardiography,left ventricular(LV) end-systolic volume,end-diastolic volume and left ventricular ejection fraction(LVEF) were calculated by bi-plane simpson′s method.The peak velocity during early diastole(Ve) and late diastole(Va) of anterior mitral valve were measured by pulse-waved doppler,and the ratio Ve/Va was calculated.We acquired the apical four-chamber,two-chamber and the long-axis views of the left ventricular images in these patients with GE-Vivid7-dimension.Then the peak longitudinal velocity,strain and strain rate in systolic period were measured and recorded.Results The values of LAD,LVESV and LVEDV in DCM patients were significantly higher than those of healthy subjects(P<0.01),and LVEF was significantly lower than that of healthy subjects(P<0.01).The value of Ve/Va between DCM patients and normal subjects had no difference(P>0.05).The peak velocity in systolic period of the base and middle LV segments in DCM patients were lower than those of the healthy subjects(P<0.05).The peak longitudinal strain and strain rate were significantly lower than healthy subjects(P<0.01).The peak velocity of the healthy subjects and the DCM patients were descent from the base to the apex.Conclusion The peak velocity,stain and strain rate of regional myocardial function in long-axis of left ventricular can be analyzed by 2D-STI,and it is a feasible technique for the assessment of cardiac longitudinal systolic function in DCM patients,and it can be widely used in the cardiac examination.