改进的解剖M型超声心动图对左室短轴局部心肌运动速度的评价

目的了解应用改进的解剖M型超声心动图技术评价局部心肌运动速度的可行性。方法随机选取40例正常人和25例扩张型心肌病(DCM)心衰患者,应用改进的解剖M型超声对胸骨旁左室短轴切面三个水平的前间隔和后壁的收缩期、舒张早期及舒张晚期的峰值速度(即S峰、E峰、A峰)分别进行采集和测量。并在组织多普勒超声定量组织速度成像模式(QTVI)下,分别检测相应的峰值速度,比较两种技术在测量相同部位和时相峰值速度的差异及相关性。同时应用改进的解剖M型技术对短轴同一平面(乳头肌水平)各个节段局部心肌的三个时相运动速度进行比较。再由两个检测者应用此技术在双盲条件下,对乳头肌水平部分峰值速度进行重复性检验。结果改进的解剖M型超声测值与组织多普勒测值较接近,但前者多数略高于后者。一致性检验显示,在正常组和DCM心衰组有部分数据两种技术的测值差异具有统计学意义(P<0.05)。相关性分析显示,两种技术检测结果相关性好。应用改进的解剖M型技术对同一平面各个节段局部心肌运动速度进行比较,仅在小部分峰值速度略有差异。两个检测者的重复性检验结果未见统计学差异(P>0.05)。结论改进的解剖M型超声在评价心肌局部运动方面是一种可行的、有待开发完善的新技术。

Evaluation of regional myocardial velocity of left ventricular short axis by improved anatomic M-mode echocardiography

Objective To evaluate the feasibility of regional myocardial velocities by applying improved anatomic M-mode(AMM)echocardiography.Methods Forty normal subjects and 25 dilated cardiomyopathy(DCM)patients with congestive heart failure were randomly selected.Using the improved anatomical M-mode echocardiography to parasternal short axis view of left ventricular anterior septal and posterior wall of the three levels of systolic,early and late diastolic peak velocities(S peak,E,A)were collected and measured.Under quantitative tissue Doppler imaging,corresponding to the peak velocities were measured.Then to compare the result of contrast and relevance between improved anatomic M-mode and TDI in the same location and phase.Meanwhile myocardial different segments of the three-phase velocities of the same plane short axis(papillary muscle level)were compared by applying improved anatomic M-mode echocardiography.Two detectors in double-blind conditions repetitively test some peak velocities of the papillary muscle level.Results The measurements of improved AMM and TDI were more close,but the former was slightly higher than the latter.Consistency check showed that parts of the data between two technologies in the normal and DCM groups were statistically significant.Correlation analysis showed that the good relationship between the two technology results.Comparing in the various segments of the same plane for myocardial velocity by applying improve AMM,only a small number of peak velocity was slight differences.The two reproducible test results showed no statistically significant difference.Conclusion Improved anatomical M-mode echocardiography in the evaluation of regional myocardial kinesi is a viable new technology needing development.