速度向量成像技术评价风湿性心脏病二尖瓣狭窄左心房功能

目的 探讨速度向量成像(velocity vector imaging,VVI)技术评价左心房功能的临床价值.方法 应用VVI技术测量38例风湿性心脏病二尖瓣狭窄(rheumatic mitral stenosis,RMS)患者和42例健康志愿者(对照组)左心房12节段的收缩期纵向峰值应变(S),纵向收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)、舒张晚期峰值应变率(SRa)以及SRa达峰时间差值(Td-SRa).结果 与对照组比较,RMS组左心房12节段S、SRs、SRe测值均减低(P<0.05),各节段SRa测值除主动脉侧基底段以外均减低(P<0.05).RMS组中心房颤动(atrial fibrillation,AF)患者左心房各节段SRa缺失比例约56%,舒张晚期无规律的往返心房的低振幅运动约18.6%,能分辨的舒张晚期正向峰值约25.4%.RMS组AF患者与组内窦性心律患者比较,左心房后壁基底段及中间段SRa测值减低(P<0.05).RMS组Td-SRa测值增大,时间延长(P<0.05),尤以AF患者更为明显.结论 VVI技术能够定量评价RMS患者左心房节段及整体功能,为临床评价左心房功能提供了又一有效方法.

Evaluation of left atrial function by velocity vector imaging in patient with rheumatic mitral stenosis

Objective To evaluate left atrial function by velocity vector imaging (VVI) in patients with rheumatic mitral stenosis(RMS). Methods Thirty eight patients with RMS and 42 normal controls were studied with VVI analysis software. Peak systolic strain (S), systolic strain rate(SRs), early diastolic strain rate(SRe) and late diastolic strain rate(SRa) of each left atrial segments were measured,and also the SRa peak time delay(Td-SRa). Results Comparing to the controls group, the S, SRs and SRe of all segments were significantly lower(P<0.05). Except the base latero-aorta's SRa, the other segments' SRa were lower (P<0.05). In patients with atrial fibrillation(AF),56% segments had no SRa,and 18.6% had irregular low amplitude movement at late diastole, while 25.4% had discernible positive peak. The base and middle inferior SRa of patients with AF were lower (P<0.05 ) than those of the patients with sinus rhythm. While the Td-SRa of patients was longer than that of control group,especially what of the patients with AF. Conclusions The segmental and globe left atrial function of patients with RMS can be evaluated with VVI.