缺血性心肌病左室舒张功能的二维应变显像研究

目的 应用二维应变左室旋转角度研究缺血性心肌病型冠心病患者左室心肌舒张功能的变化特点.方法 18例缺血性心肌病伴左室射血分数减低患者(EF＜50%,32%±8%)及20例正常对照组纳入本研究,应用二维应变(STI)技术分别测量舒张期左室心肌短轴面旋转角度(LV-RA)进行对比研究.结果 病例组心尖部及心底部心肌旋转角度绝对值均较正常对照组低(心尖部:2.3°±0.9° vs 4.4°±2.0°;心底部:1.8°±1.0° vs 3.0°±1.2°;P＜0.05);正常对照组短轴心尖部旋转角度绝对值较心底部为高(4.4°±2.0° vs 3.0°±1.2°;P＜0.05);病例组心尖部旋转角度绝对值与心底部无统计学差别(2.3°±0.9° vs 1.8°±1.0°;P＞0.05).病例组左心室短轴旋转角度与左房容量指数相关(LA volume index,r=-0.73,P＜0.05).结论 LV-RA在心肌缺血左室收缩功能不全时有所降低,LV-RA能够用以评价缺血性心肌病时的左室舒张功能变化并可能为心肌病左室舒张功能的评价提供一种新的方法.

Diastolic Function Study during Ischemic Myocardial Disease Using Speckle Tracking Imaging

Objective To investigate the diastolic function characteristic using left ventricle rotation in patients with ischemic myocardial disease(IMD).Methods 18 cases of IMD with eject fraction (EF)(EF＜50%,32%±8%)and 20 normal controls were enrolled in this study.Left ventricle rotation angle during diastole was mea sured by speckle tracking and compared.Results Both apcial and basal rotation angel were lower in patients group than those in normal controls (apex:2.3°±0.9°vs 4.4°±2.0°; basal:1.8°±1.0°vs 3.0°±1.2°;P＜0.05).Apcial rotation angel was higher than basal in normal controls(4.4°±2.0° vs 3.0°±1.2°,P＜0.05)and no such difference was found in patients(2.3°±0.9°vs 1.8°±1.0°,P＞0.05).The left ventricular rotation in patients was linearly correlated with left atrial volume index (r=-0.73,P＜0.05).Conclusions Left ventricle rotation during diastole was decreased in IMD patients with decreased systolic function,and maybe a promising way for diastolic function assessment during IMD and other myocardial diaeases.