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二维应变超声心动图定量评价左心室整体和局部心肌应变的价值
引用本文:张烨,李治安,杨娅,何怡华,孙琳,谷孝艳.二维应变超声心动图定量评价左心室整体和局部心肌应变的价值[J].中华超声影像学杂志,2007,16(7):564-567.
作者姓名:张烨  李治安  杨娅  何怡华  孙琳  谷孝艳
作者单位:100029,北京,首都医科大学附属安贞医院超声科
基金项目:教育部高等学校博士点科研基金资助(20060025001);北京市优秀人才基金资助(20051D0300619)
摘    要:目的探讨二维应变超声心动图(2D-SE)定量评价心肌局部和整体应变的临床应用价值。方法分别采集25例心力衰竭患者与30例正常对照者心尖左室长轴、心尖四腔和心尖左室二腔观的二维灰阶动态图像。应用自动功能成像软件自动测量长轴方向左室18节段收缩应变(εs)和心尖左室长轴观总应变(GLS-LAX)、四腔观总应变(GLS-A4C)、二腔观总应变(GLS-A2C)及左室长轴平均总应变(GLS-Avg)。同时采用二维Simpson法分别测量三个切面观的左室射血分数(2D-EF)。比较心力衰竭组与对照组各参数测值,分析2D-EF与二维应变(2D-GLS)的相关性。结果心力衰竭组18个节段的εS、GLS-LAX、GLS-A4C、GLS-A2C及GLS-Avg均显著低于正常组(P〈0.001)。2D-EF与2D-GLS有良好的相关性(r=0.94)。正常对照组各室壁自基底段向心尖段εS逐渐增加,各壁间差异无统计学意义;扩张型心肌病组各段室壁εS绝对值均明显低于正常对照组(均P〈0.05),各节段间差异无统计学意义;前壁心肌死梗组中左前降支供血节段的εS绝对值明显低于正常对照组。结论2D-SE可用于定量测量左室整体和局部心肌的应变,为临床提供了一种快速准确、操作简便、可重复性好的无角度依赖的定量左室功能的新方法。

关 键 词:超声心动描记术  心力衰竭  充血性  心室功能    二维应变
收稿时间:2006-10-18
修稿时间:2006-10-18

Evaluation of two dimensional strain echocardiography in quantifing global and regional wall strain of left ventricle
ZHANG Ye,LI Zhian,YANG Ya,HE Yi-hua,SUN Lin,GU Xiao-yan.Evaluation of two dimensional strain echocardiography in quantifing global and regional wall strain of left ventricle[J].Chinese Journal of Ultrasonography,2007,16(7):564-567.
Authors:ZHANG Ye  LI Zhian  YANG Ya  HE Yi-hua  SUN Lin  GU Xiao-yan
Institution:Department of Ultrasound ,Beijing Anzhen Hospital ,Capital University of Medical Science ,Beijing 100029, China
Abstract:Objective To investigate the clinical value of two dimensional strain echocardiography(2D-SE) in quantifing global and regional myocardial strain.Methods There were 25 cases with heart failure in the patient group,while 30 healtyhy subjects in the control group.The two-dimensional loop-cinec were obtained in apical 4-chamber view,apical 2-chamber view and long axis of left ventricle(LV) view.Eighteen segments of LV longitudinal peak systolic strain and global peak systolic strain of each view were measured by automated functional imaging(AFI) software of 2D-SE.LV ejection fraction (EF)of each view was calculated by Simpson's method.Values were compared between the two groups .The correlations between 2D-EF and 2D-SE were analyzed respectively.Results All parameters were significantly higher in the control group than those in the heart failure group(P<0.001).LV longitudinal peak systolic strain of control group were significantly increasing from basal mid to apical segments.In addition,the 2D-global strain correlated significantly with 2D-EF.Peak systolic strain of 18 segments in the dilated cardiomyopathy group were significantly lower than those of the control gorup(P<0.05),but the difference between each wall was not significant(P>0.05).When infarction segments of anterior myocardial infarction group compared with the control group,peak systolic strain was significantly lower than in corresponding segment of control subjects(P<0.05).Conclusions 2D-SE is a rapid and precise,angle-independent tool to assess the global and regional myocardial strain of left ventricular wall quantitatively,providing useful modality for evaluation cardiac systolic function.
Keywords:Echocardiography  Heart failure  congestive  Ventricular function  left  Two-dimensional strain
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