三平面组织成像技术初步评价心肌梗死后左室收缩的非同步性

目的初步探讨ST段无抬高心肌梗死患者的左室失同步化特点,确立其失同步化指标。方法用3V探头分别采集15例正常成人(正常组)及15个心肌梗死患者(心梗组)的左室心尖四腔图,应用三平面成像技术同时显示心尖二腔图及心尖长轴图,测量每个对象左室12节段(6个基底段和6个中间段)的收缩期达峰时间及各项同步化指标,并进行统计分析。结果 1心梗组患者的收缩期达峰时间较正常组有不同程度延长,且差异有统计学意义。2室隔/侧壁延迟:正常组以室隔延迟为主,延迟时间最长为38 ms;心梗组以侧壁延迟为主,延迟时间最长117 ms。3心梗组与正常组比较:△TS-12(101.9±52.9 vs.67.3±30.2,P﹤0.05),标准差(34.1±18.5 vs.22.3±11,P﹤0.05);△TS-4(62.5±36.1 vs.35.8±24.4,P﹤0.05);△TS-6(67.2±37.1 vs.43.1±26.1,P﹤0.05)。结论三平面组织成像技术方法简便,能定量反映左室壁收缩活动的延迟情况;△TS-12及标准差、△TS-6、△TS-4这四项指标可用于评价ST段无抬高心梗患者的左室失同步化情况。

Primary evaluation of left ventricular contraction asynchrony after myocardial infarction using 3-plane tissue imaging

Objective To evaluate the characteristics of left ventricular （LV） asynchronous contraction in patients with non-ST elevation myocardial infarction, to establish the parameters of left ventricular asynchrony. Methods The LV apical 4- chamber view of 15 normal people （control group） and 15 non-ST elevation myocardial infarction patients （myocardial infarction group） were observed with 3v probe in GE ViVid 9, the apical 2- chamber and the apical long-axis view were displayed using 3- plane TSI,the time to peak systolic velocity of LV12 segments （6 basal segments and 6 mid-segments） and each parameter of synchrony were measured and analyzed statistically. Results Compared with the control group, the time to peak systolic velocity was delayed in myocardial infarction group, there was significant difference. Septal -lateral delay showed that septal delay was mainly found in normal people with the longest delay time of 38ms,while the lateral delay was mainly found in myocardial infarction patients with the longest delay time of 117ms. There was significant difference of △TS-12 （ 101.9 ± 52.9 vs. 67.3 ± 30.2,P〈 0.05） and standard deviation （34.1 ± 18.5 vs. 22.3 ± 11 ,P〈 0.05）,△TS-4 （62.5 ± 36.1 vs. 35.8 ± 24.4,P〈 0.05）, △TS-6（67.2 ± 37.1 vs. 43.1 ± 26.1, P 〈 0.05 ） between the two groups. Conlusion 3-plane tissue imaging is easy to operate and it can indicate the delay of left ventricular contraction quantitatively. The parameter of △TS-12 and standard deviation, △TS-6, △TS-4 can be used to evaluate the asynchrony of LV in non-ST elevation myocardial infarction patients.