组织同步化成像评价心内膜弹力纤维增生症左心室同步性的研究

探讨组织同步化成像（TSI）评价心内膜弹力纤维增生症（EFE）左心室心肌收缩和舒张运动的同步性应用价值。方法　2007年5月至2008年3月重庆医科大学附属儿童医院收住EFE患儿16例，治疗前和治疗后6个月分别采用TSI测量左心室各节段长轴方向的收缩达峰时间（TS），舒张早期达峰时间（TE）。计算12节段TS和TE的标准差（TS-SD和TE-SD），评价左心室收缩舒张同步性。对照组为同期整形外科和骨外科住院患儿20例。结果　（1）EFE组治疗前TS-SD高于对照组及EFE组治疗后，差异均有统计学意义。（2）EFE组TE-SD高于对照组，差异有统计学意义；治疗前后TE-SD差异无统计学意义。（3）EFE组左心室收缩功能明显低于对照组，治疗后有明显好转。结论　EFE患儿左心室存在以收缩不同步为主的失同步化运动，TSI检测可无创、快速定量评价左心室同步性。

Assessment of intraventricular synchrony in children with endocardial fibroelastosis using tissue synchronization imaging.

Objective　To evaluate the intra ventricular synchrony in patients with endocardial fibroelastosis with TSI. Methods　Echocardiography and tissue synchronization imaging were performed in 36 subjects：20 served as normal controls and 16 patients had endocardial fibroelastosis. They were followed up after 6 months of treatment. Tissue synchronization imaging was performed in apical view. The time to peak myocardial systolic contraction（TS）and early diastolic relaxation（TE）were measured，and the standard deviation of TS and TE of the 12 LV segments were computed，i. e. TS-SD and TE-SD. Results　（1）The standard deviation of the time to peak myocardial systolic contraction（TS） of the study group before the treatment was higher than that of the control group，and there was statistical significance. The standard deviation of the time to peak of pre-treatment was higher than that of post-treatment and there was statistical significance；（2）The standard deviation of the time to peak myocardial early diastolic relaxation （TE） of the study group before the treatment was higher than that of the control group，and there was statistical significance. There was no statistical significance in the standard deviation of the time to peak for pre-treatment and post-treatment；（3）Left ventricular systolic function of the study group was significantly lower than that of the control group，and the study group obtained a significant recovery after treatment. Conclusion　There are significant intraventricular dyssynchrony in children with endocardial fibroelastosis，but mainly at systolic contraction. TSI can feasibly and reliably assess the intraventricular synchronicity in systole and diastole.