短轴应变率评价心力衰竭患者左心室向心运动功能变化

目的探讨心力衰竭(心衰)患者左心室向心运动功能的变化。方法心衰患者30例,健康对照者30名,使用日本Toshiba Aplio彩色超声诊断仪,配有短轴多普勒组织超声软件,探头频率3.5 MHz。受试者左侧卧位,同步显示心电图。分别取左心室短轴二尖瓣水平、乳头肌水平和心尖水平,启动短轴多普勒组织超声,获得应变率图像。取12、4、6点和8点应变率值,并取平均值。比较2组间各项指标有无差异。结果心衰患者左心房、室内径较健康对照组明显扩张,射血分数减低(44.8±7.8)mm比(30.8±2.8)mm,(54.8±3.8)mm比(44.8±4.8)mm,(37.5%±10.3%)比(65.3%±12.5%),均为P0.05]。在向心运动过程中,健康对照组的短轴应变率较心衰组高,两组差异有统计学意义(均为P0.05)。结论短轴应变率可以准确定量反映左心室向心运动,其中短轴平均应变率可以显示心衰患者左心室短轴功能变化。

Assessment of left ventricular radial movement with short-axis strain rate in patients with heart failure

Objective To evaluate left ventricular short-axis function by short-axis strain rate in patients with heart failure （HF）. Methods Thirty HF patients and 30 healthy people were examined with color Doppler ultrasonography. Left ventricular short-axis sections were obtained at mitral valve level, papillary level and apical level. Straining rate graph was displayed by running the short-axis tissue Doppler imaging quantification （TDI-Q）. Values measured at 12, 4, 6 and 8 o＇clock positions were recorded and mean values of straining rate were calculated respectively. Results Compared with healthy people, the diameters of left atrium and left ventricle were longer in HF patients. However, left ventricular ejection fraction（LVEF） and the mean value of strain rate were decreased in HF patients. Conclusions Short-axis TDI-Q can be used as an accurate quantitative measurement for left ventricular radial movements. The mean short-axis strain rate indicates left ventrieular short-axis function in HF patients.