实时三维斑点追踪成像评价心肌梗死左心室整体收缩功能的可行性和重复性研究

目的应用实时三维癍点追踪成像（RT-3DSTI）测量心肌梗死收缩期左心室心肌整体峰值纵向应变（GPSL）、整体纵向应变（GLS）、整体圆周应变（GCS）、整体面积应变（GAS）及整体径向应变（GRS），探讨其评价左心室整体收缩功能的可行性和重复性。方法83例研究对象，包括心肌梗死患者38例，健康对照者45例；采用RT-3DSTI测量收缩期左心室GPSL、GLS、GCS、GAS、GRS；分析心肌梗死组RT-3DSTI特征，并探讨其与实时三维超声（RT-3DE）测量射血分数的相关性；随机选取20例心肌梗死患者，用Bland-Altman法研究RT-3DSTI在观察组内和观察组间的重复性。结果（1）心肌梗死组收缩期左心室GPSL、GLS、GCS、GAS、GRS显著低于对照组，差异有统计学意义（P〈O01）；（2）ROC曲线显示GPSL、GLS和GAS能反映心肌梗死组整体应变的变化；（3）GPSL、GLS、GCS、GAS及GRS与RT-3DE射血分数有良好的相关性；（4）Bland-Altman法显示心肌梗死患者RT-3DSTI测量在观察组内和观察组间均有良好的一致性。结论RT-3DSTI可简便快速评价·,22肌梗死左心室整体收缩功能，其测量左心室整体功能不依赖左心室负荷变化的影响，可能是一种评价左心室整体收缩功能有前景的技术，

Evaluation of Global Left Ventricular systolic Function in Patients with Myocardia Infarction Using three-Dimensional Strain Imaging

Objective The paper is aimed at exploring and evaluating left ventricle systolic function＇ s practical meaning by using RT-3DSTI to measure speckle tracking＇ s GPSL, GLS, GCS, GAS and GRS. Methods With 83 patients cases including 38 patients diagnosed with myocardial infarction and 45 patients of healthy control group, the paper takes way of RT-3DSTI to measure the systolic left ventricular GPSL, GLS, GCS, GAS, GRS, analyses the characteristics of myocardial infarction group RT-3DSTI, explores its relationship with the real-time three-dimensional echocardiography（RT-3DE） measurement of ejection fraction. Besides, the Bland-Airman method is used to research myocardial infarction group RT-3DSTI in the observation group and the observation group and the consistency. R~tlts （1）GPSL, GLS, GCS, GAS, GRS＇ s measurement of myocardial infarction group systolic left ventricular is significantly lower than the control group＇ s. The difference was statistically significant（P〈0.01）. （2）The ROC curve display, GPSL, GLS and GAS can display the change of left myocardial infarction overall strain accurately. （3）There was a good correlation between GPSL, GLS, GCS, GAS and GRS and RT-3DE ejection fraction. （4}Bland-Altman method shows that the consistency of RT-3DSTI in patients with acute myocardial infarction in the observation group measurement and observation group has a good consistency. Conclusions RT-3DSTI can simply and quickly evaluate the systolic global left ventriculat myocardial function which does not depend on left ventricular load change, and this method may be an overall assessment of left ventricular systolic function oromising technology.