STI评估左心室逆重构扩张型心肌病患儿左心室收缩功能

目的 探讨扩张型心肌病（DCM）患儿左心室逆重构（LVRR）前后左心室局部心功能变化。方法 收集24例临床诊断为DCM并经治疗达到LVRR标准的患儿，并选取性别和年龄、体表面积分别与患儿发生LVRR前与发生LVRR后相匹配的各24名健康儿童分别作为对照组1及对照组2。应用STI定量评估受检儿常规超声心功能参数、左心室各节段纵向应变（LS）和圆周应变（CS）。分别比较24例DCM患儿LVRR前与LVRR后、LVRR前与对照组1及LVRR后与对照组2各参数的差异。结果 24例DCM患儿LVRR后LVEDD、LVEDV、LVESV均低于LVRR前，而LVEF、左心室各节段LS及CS均高于LVRR前（P均<0.05）。与对照组1相比，DCM患儿LVRR前左心室各节段LS及CS均降低（P均<0.05）；与对照组2相比，DCM患儿LVRR后有12个节段LS及10个节段CS均降低（P均<0.05），其余节段LS与CS与对照组2比较差异均无统计学意义（P均>0.05）。结论 DCM患儿发生LVRR后左心室整体及局部收缩功能较LVRR前有明显好转，但多数左心室节段收缩功能仍未恢复至正常水平。

STI in evaluation on left ventricular systolic function in children with reverse-remodeled dilated cardiomyopathy

Objective To evaluate the changes of left ventricular systolic function before and after left ventricular reverse-remodeled (LVRR) in children with dilated cardiomyopathy (DCM). Methods Totally 24 children with clinically diagnosed DCM and achieved LVRR after treatment were collected, while 48 healthy children with matched age, sex and body surface area pre-and post-LVRR were enrolled in control group 1 (n=24) and control group 2 (n=24), respectively. Routine echocardiographic functional parameters, left ventricular longitudinal strain (LS) and circumferential strain (CS) were evaluated with STI. The above parameters between DCM children pre-and post-LVRR, DCM children pre-LVRR and control group 1, as well as DCM children post-LVRR and control group 2 were compared. Results LVEDD, LVEDV, LVESV of DCM children post-LVRR were lower than those of DCM children pre-LVRR, while LVEF, LS and CS of left ventricular were higher than those of DCM children pre-LVRR (all P<0.05). Compared with control group 1, LS and CS decreased in all segments of left ventricular of DCM children pre-LVRR (P<0.05). Compared with control group 2, there were 13 segments of LS and 10 segments of CS decreased of DCM children post-LVRR (P<0.05). There was no significant difference of LS nor CS for remaining segments between DCM children post-LVRR and control group 2. Conclusion Left ventricular systolic function was improved in DCM children after LVRR, but myocardial function of many segments could not return to normal.