三维斑点追踪成像技术定量评价肾移植受者术后左心室整体应变

目的  探讨采用三维斑点追踪成像（3D-STI）技术定量评价肾移植受者术后3个月内左心室整体应变的应用价值。方法  选取34例肾移植受者，分别于术前、术后7 d、术后1个月、术后3个月收集受者的血压、血清肌酐和他克莫司血药浓度等资料，同时对受者行常规超声心动图和3D-STI检查，收集受者超声心动图检查参数左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室射血分数（LVEF）]和3D-STI检查参数左心室整体纵向峰值应变（GPLS）、整体圆周峰值应变（GPCS）、整体径向峰值应变（GPRS）及整体面积峰值应变（GPAS）]。比较受者术前、术后7 d、术后1个月、术后3个月上述指标的变化，分析应用3D-STI技术定量评价肾移植受者术后3个月内左心室整体应变的变化特点及其应用价值。结果  肾移植受者术前至术后3个月内各时间点间LVEF和GPCS比较，差异均无统计学意义（均为P > 0.05）。术前至术后3个月内各时间点间LVEDV、LVESV、GPLS、GPAS和GPRS比较，差异均有统计学意义（均为P < 0.001）。GPLS、GPAS、GPRS在术后1个月内呈连续下降趋势，术后3个月有所上升但仍低于术前水平。结论  应用3D-STI技术能够敏感地发现肾移植受者术后LVEF未见明显改变时左心室整体应变的改变，与常规超声心动图比较，3D-STI可以更准确地评价肾移植受者术后左心室整体应变的变化特点。

Three-dimensional speckle tracking imaging for quantitative evaluation of left ventricular global strain in renal transplant recipients

Objective To evaluate the application value of three-dimensional speckle tracking imaging (3D-STI) in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation. Methods Clinical data including blood pressure, serum creatinine and tacrolimus blood concentration of 34 renal transplant recipients were collected before operation, 7 d, 1 month and 3 months after operation, respectively. Meanwhile, conventional echocardiography and 3D-STI examination were performed. Echocardiographic parameters left ventricular end-diastolic volume (LVEDV), left ventricular end-systolic volume (LVESV) and left ventricular ejection fraction (LVEF)] and 3D-STI parameters left ventricular global peak longitudinal strain (GPLS), global peak circumferential strain (GPCS), global peak radial strain (GPRS) and global peak area strain (GPAS)] of recipients were collected. The changes of these parameters before operation, 7 d, 1 month and 3 months after operation were statistically compared. The changing characteristic and application value of 3D-STI in quantitatively evaluating the left ventricular global strain in recipients within 3 months after renal transplantation were evaluated. Results LVEF and GPCS did not significantly differ at different time points (all P > 0.05), whereas LVEDV, LVESV, GPLS, GPAS and GPRS significantly differed at different time points from preoperative to within postoperative 3 months (all P < 0.001). GPLS, GPAS and GPRS trended to decline within postoperative 1 month, and slightly increased at 3 months after operation, which was still lower than the preoperative levels. Conclusions Application of 3D-STI may sensitively detect the changes of left ventricular global strain in recipients after renal transplantation when no significant variations are observed in postoperative LVEF. Compared with conventional echocardiography, 3D-STI may more accurately evaluate the changes of left ventricular global strain in recipients after renal transplantation.