应用超声斑点追踪技术评价室间隔缺损封堵前后心脏扭转运动的变化

目的:运用二维超声斑点追踪技术评价经皮室间隔封堵术前后患者心脏扭转运动的变化.方法:检测18例室间隔缺损患者封堵术前、术后第3天、术后1个月、术后3个月的常规心脏二维多普勒超声参数,并运用二维斑点追踪技术对患者的左心室旋转及扭转运动进行分析,以探讨室间隔缺损封堵术对其心脏扭转运动的影响.结果:封堵术后第3天,舒张期末左室内径(LVEDd)、左室舒张末容积(LVEDV)较术前减低较明显,左心室的基底部、心尖部的旋转角度及整体的扭转运动的角度较术前稍有减低.术后1个月、术后3个月,LVEDd、LVEDV较术前仍有降低,但降低的程度有减小的趋势;而左心室的基底部、心尖部的旋转角度及整体的扭转运动的角度仍有降低,降低的程度以术后1个月最明显,以后降低程度减小.患者封堵术前、术后第3天、术后1个月、术后3个月的LVEF稍有改变,但差异尤统计学意义.无论是封堵术前、术后第3天、术后1个月、还是术后3个月有,病人的左心室的基底部、心尖部的旋转角度峰值及整体的扭转运动的角度峰值均和LVEF呈线性相关,且以左室整体的扭转运动的角度峰值和LVEF的相关性最好.结论:经皮室间隔缺损封堵术通过逆转左室的重构而改善左室的扭转运动,且左室整体的扭转运动与LVEF的相关性最好.

Evaluation the changes of left ventricular rotation and twist using speckle tracking imaging after transcatheter closure of VSD

Objective:To investigate the left ventricular rotation and twist in patients with ventricular septal defect(VSD)after transcatheter closure of VSD.Methods:Using speckle tracking imaging(STI),the roation of 6 segments of basal and apical short-axises and LV twist were measured repeatedly in 18 patients with VSD before surgery,in 3rd day,1st month,3rd month after surgery.The global roation of the 6 segments in basal and apical short-axises and LV twist versus time profile were drawn,and the peak rotation of b...