斑点追踪成像技术对心尖肥厚型心肌病左心室功能的评价

目的 应用三维斑点追踪成像（three-dimensional speckle tracking imaging,3D-STI）技术评价心尖肥厚型心肌病（apical hypertrophic cardiomyopathy,AHCM）患者的左心室收缩功能。方法 收集AHCM患者21例(AHCM组)及健康志愿者21例(对照组)，均进行常规二维超声心动图和3D-STI检查，获得并存储左心室三维动态图像，用4D AUTO LVQ软件分析处理。比较2组三维左心室心功能检测值及左心室整体及各节段的纵向应变（longitudinal strain，LS）、圆周应变（circumferential strain，CS）、面积应变（area strain，AS）、径向应变（radial strain，RS）的参数及曲线。结果 AHCM组LVEDV和SV低于对照组（P＜0.05）。AHCM组整体LS、整体CS、整体AS、整体RS值均低于对照组（P＜0.01）。AHCM组二尖瓣水平前壁、侧壁、后壁和后间隔LS值低于对照组；乳头肌水平各部位LS、AS、RS值低于对照组，前间隔、前壁、侧壁、后壁CS值低于对照组；心尖水平各部位应变值均低于对照组，差异有统计学意义（P＜0.05或P＜0.01）。结论 AHCM患者的左心室整体收缩功能有不同程度的减低，而左心室局部收缩功能减低以心尖水平最为明显，乳头肌水平同时受累。3D-STI可以反映AHCM患者左心室整体及各节段收缩功能的变化。

Assessment of left ventricular function by three-dimensional speckle tracking imaging in patients with apical hypertrophic cardiomyopathy

Objective〖HTSS〗To assess the left ventricular systolic function in apical hypertrophic cardiomyopathy（AHCM） with three-dimensional speckle tracking imaging(3D-STI). 〖WTHZ〗Methods〖HTSS〗Twenty-one AHCM patients (AHCM group) and 21 healthy volunteers(control group) were selected for routine two-dimensional echocardiography and 3D-STI examination. Three-dimensional dynamic images of left ventricle were obtained and stored, and analyzed by 4D AUTO LVQ software. The parameters and curves of longitudinal strain(LS), circumference strain(CS), area strain(AS) and radial strain(RS) were compared between two groups. 〖WTHZ〗Results〖HTSS〗LVEDV and SV were lower in AHCM group than those in control group(P＜0.05). The values of global LS, CS, AS and RS in AHCM group were all lower than those in the control group(P＜0.01). Compared to the control group, the LS values of anterior wall, lateral wall, posterior wall and posterior interval of the mitral valve level were lower. At papillary muscles level, the LS, AS and RS values of all segment were lower, and the CS values of anterior, anterior wall, lateral wall andposterior wall interval were lower. All of the strain values of the apex level were lower in AHCM group.The above differences were statistically significant(P＜0.05 or P＜0.01). 〖WTHZ〗Conclusion〖HTSS〗In patients with AHCM, the global systolic function of left ventricular decreased to different degrees, while the segment systolic function of the left ventricular reduced most obviously at the apex level, and the papillary muscle level is also affected. 3D-STI can reflect the variations of left ventricular global and segmental systolic function in AHCM patients.