定量组织速度成像与二维应变成像评价冠心病左心室局部收缩功能

目的 应用定量组织速度成像(QTVI)及二维应变(2DS)检测冠心病患者心肌运动速度和应变率(SR)的变化,探讨其评价冠心病患者心肌局部收缩功能的价值.方法 对心绞痛组20例,心肌梗死组25例,正常对照组30名,应用QTVI及2DS分别获得左心室乳头肌水平短轴切面的动态图像,通过测量前壁和下壁心内膜下心肌收缩期运动速度(Vendo)和心外膜下心肌收缩期运动速度(Vepi),计算相应心肌的应变率(TVI-SR),并用2DS测量局部心肌的应变率(2DS-SR).结果 三组左心室下壁的运动幅度、室壁增厚率、速度和SR差异均无统计学意义.与正常对照组比较,心绞痛组和心肌梗死组前壁的Vendo、TVI-SR、2DS-SR明显下降;与心绞痛组比较,心肌梗死组前壁上述指标也均明显下降,且较室壁运动幅度和室壁增厚率下降明显.结论 QTVI和2DS可以敏感地评价心肌缺血时心脏局部收缩功能.

Evaluation of left ventricular regional systolic function with quantitative tissue velocity imaging and two-dimensional strain in patients with coronary heart disease

Objective To assess the value of myocardium velocity and strain rate in assessing left ventricular systolic function with quantitative tissue velocity imaging (QTVI) and two-dimensional strain (2DS) in patients with coronary heart disease (CHD). Methods Twenty patients with angina, 25 patients with myocardial infarction and 30 controls were studied by means of QTVI and 2DS, in order to analyze the systolic velocity curve and strain rate (SR) curve of the left ventricular short-axis view at the mid-papillary muscle level. The endocardium velocity (Vendo), epicardium velocity (Vepi) and SR of the anterior and inferior were measured and calculated. Results No significant difference of wall motion, wall-thickening fraction, velocity and SR of inferior wall was found among three groups. Vendo, TVI-SR and 2DS-SR of anterior wall in angina and myocardial infarction group obviously descended compared with control group. Those indexes in infarction group decreased obviously compared with angina group, and decreased more obviously than wall motion and wall thickening fraction did. Conclusion QTVI and 2DS can sensitively evaluate left ventricular local systolic function in patients with myocardial ischemia.