斑点追踪技术评价室间隔缺损封堵术对左心室扭转运动的早期影响

目的 探讨二维斑点追踪技术评价经皮室间隔封堵术对左心室扭转运动的早期影响.方法 对36例室间隔缺损患者封堵术前、术后3 d的常规心脏超声指标进行检测,并运用二维斑点追踪技术对患者左室旋转及扭转运动进行分析.结果 封堵术后3 d,左室舒张末期内径(LVEDd)、左室舒张末期容积(LVEDV)较术前减小,左室基底部、心尖部旋转角度及整体扭转运动角度较术前减低.与术前相比,基底部后壁、下壁、后间隔顺时针旋转角度峰值降低(P<0.05),其余9个节段的旋转角度峰值降低,但差异无统计学意义(P>0.05).封堵术前、术后3 d左室射血分数(LVEF)稍有改变.但差异无统计学意义(P>0.05).左室整体扭转运动角度峰值与LVEF、LVEDV呈线性相关.结论 左室扭转运动可作为评价心脏收缩功能较敏感的指标.

Evaluation of acute changes of left ventricular rotation and twist after transcatheter closure of ventricular septal defect using speckle tracking imaging

Objective To investigate the left ventricular(LV)rotation and twist in patients with ventricular septal defect(VSD)after transcatheter closure of VSD.Methods Using speckle tracking imaging(STI),the roation of 6 segments of basal and apical short-axises and LV twist were measured repeatedly in 36 patients with VSD before closure and in 3rd day after closure.The peak roation of 6 segments of basal and apical short-axises and peak global roation of the basal and apical short-axises and peak LV twist were caculated.LV end-diastolic diameter(LVEDd)and LV end-diastolic volume(LVEDV)were caculated.LV ejection fraction(LVEF)was measured by biplane Simpson method.Results The peak roation of basal and apical short-axises and peak twist of LV twist in 3rd day after closure were lower(P<0.05).LVEDd and LVEDV were significantly reduced in 3rd day after closure(P<0.05).There were no significant differences in LVEF.The peak twist of LV had a significant correlation with LVEF and LVEDV.Conclusions LV roation and twist may be a new index for predicting LV systolic function.