二维超声斑点追踪显像技术在评价AMI患者左心室扭转运动中的应用

目的 观察二维超声斑点追踪显像（STI）技术评价急性心肌梗死（AMI）患者左室收缩功能的价值.方法 选择60例AMI患者（AMI组）及20例健康查体者（对照组）,均采用彩色多普勒超声仪以Simpson′s法测量左室射血分数（LVEF）及二尖瓣血流E峰/A峰,以STI技术测量左室心尖和心底各个节段旋转角度,同步记录左室整体扭转峰值（Ptw）、心尖扭转角度峰值（PAR）、心底扭转角度峰值（PBR）、收缩末期末左心室扭转角度（AVCtw）、等容舒张期末扭转角度（MVOtw）、解旋率（UntwR）、解旋减半时间（HTU）,并分析左室扭转参数与LVEF、E峰/A峰的相关性.结果 AMI组Ptw、 PAR、AVCtw、MVOtw明显低于对照组（P〈0.05）,其中前壁心梗者PAR显著低于下壁及前间壁心梗者（P〈0.05）;Ptw与LVEF呈显著正相关（r=0.527,P〈0.05）,UntwR与E峰/A峰无明显相关.结论 STI技术可通过定量检测收缩期左室扭转运动较好的评价AMI患者左室收缩功能改变,是指导临床诊治的新型无创性方法.

Application of two-dimensional speckle tracking imaging in the assessment of left ventricular twist in patients with acute infarcted myocardial

Objective To evaluate the value of two-dimensional speckle tracking imaging（STI） in the assessment of left ventricular twist in patients with acute infarcted myocardial （AMI）. Methods Sixty patients with AMI （AMI group） and 20 healthy subjects（control group） were selected , LVEF was measured with Simpson＇s method and Peak E/Peak A of mitral valve blood flow was measured by color Doppler, rotation were measured in the left ventricular basal and apical short- axis views using STI, LV Peak twist（Ptw） ,apical Peak rotation （PAR）, the basal Peak rotation （PBR） and the time to Prot were measured separately, twist at aortic valve closure（ AVCtw）, twist at mitral valve opening （MVO tw）, untwisting rate（ Untw R）, and half time of untwisting （ HTU ） were calculated. The correlation was analyzed between LV twist and LVEF,peak E/peak A. Results Compared with the control group , the value of Ptw, PAR, AVCtw and MVOtw signifi- cantly decreased in observed group, the value of PAR decreased in anterior wall myoctardia ones compared with inferior wall and anteroseptal myoctardia ones （ P 〈 0.05 ） ; Significant correlation was found between Ptw and LVEF （ r = 0. 527, P 〈 0.05）, but not found between UntwR and peak E/peak A. Conclusions TI can evaluate the systolic function changes of left ventricular by measuring its twist . STI can be the new method to guide clinic diagnosis and therapy.