三维斑点追踪技术评价心脏移植患者术后早期左心功能

 目的  应用三维斑点追踪技术评价心脏移植患者术后早期左心功能的变化情况。方法  分析55例心脏移植患者的三维超声图像,运用后处理软件评价术后1个月及术后12个月左室收缩功能、容积等指标,比较术后早期左心功能的变化。结果  55例心脏移植患者中2例失访,其余53例中10例出现了排异反应(排异组),43例未出现排异反应(无排异组)。组内比较发现排异组术后12个月左室舒张末容积(left ventricular end diastolic volum,LVEDV)、左室收缩末容积(left ventricular endstolic volume,LVESV)、左室每搏量(left ventricular stroke volume,LVSV)和心肌质量(MASS)较术后1个月明显减小,无排异组术后1个月及12个月左心功能无明显差异。组间比较发现术后1个月两组左心功能无明显差异,而术后12个月排异组LVEDV、LVSV、MASS、左室整体长轴应变(GPSL)较无排异组明显减小(P值均<0.05)。结论  心脏移植术后早期左心功能发生变化,三维斑点追踪技术能较灵敏地反映心脏移植患者左心功能的变化。

Assessment of early left heart function in patients with heart transplant using three-dimensional speckle-tracking echocardiography

Objective  To assess early left heart functional alteration in patients with heart transplantaion by three-dimensional speckle-tracking echocardiography. Methods  Three-dimensional images of 55 patients with heart transplantaion were analyzed using post-processing software to evaluate and compare the left ventricular systolic function,volume and other indicators at 1 and 12 months after surgery.Results  Fifty-five patients with heart transplantaion,with 2 cases lost to follow-up,were divided into the rejection group (n=10) and the no-rejection group (n=43).Intragroup comparison showed no difference for left ventricular function between 1 month and 12 months after transplantation in the no-rejection group while in the rejection group,left ventricular end diastolic   volume (LVEDV),left ventricular end-stolic volume (LVESV),left ventricular stroke volume (LVSV),MASS at 12 months after transplantation were smaller than that at 1 month .Compared with the no-rejection group,the rejection group had similar left ventricular function at 1 month after heart transplantation,while at 12 months after surgery,their LVEDV,LVSV,MASS,and global principal longitudinal strain (GPSL) were significantly decreased (P<0.05).Conclusions  The left ventricular function had changed early after heart transplantation.Three-dimensional speckle-tracking echocardiography can accurately determine the alteration of left ventricular function in patients with heart transplantaion.