超声二维斑点追踪技术评估肥厚型心肌病左心室纵向舒张功能及舒张同步性

目的应用二维斑点追踪成像（2D-STI）技术分析肥厚型心肌病（HCM）患者的左心室纵向舒张功能及室壁运动同步性。方法连续选择非对称性肥厚型心肌病患者46例，选择同期正常人32例作为对照组。应用2D-ST1分别测量左心室长轴18节段舒张早期、晚期纵向应变率峰值（SRe、SRa）及达峰时间（TESR、TASR），并计算左心室18节段舒张早期、晚期纵向应变率达峰时间标准差（TESR-sD、TASB-sD），及任意两节段舒张早期、晚期达峰时间最大差值（TESR-Diff、TASB-Diff），比较两组上述参数。结果与对照组比较，HCM组左心室17／18节段的SRe明显减低，6／18节段SRa明显减低，HCM组的TESR-SD、TASR-SD、TESR-Diff明显增大，TASR-Diff虽较对照组有增大趋势，但无统计学意义。结论2D-STI是一种准确、定量评价HCM患者寿心窜舒张功能及同步性运动的新的无创方法。

Evaluation of Left Ventricular Longitudinal Diastolic Function and Synchronism in Patients with Hypertrophic Cardiomyopathy by Two Di-mensional Speckle Tracking Imaging.

Objective To evaluate longitudinal myocardial diastolic function and synchrony of left ventricular（LV） in patients with hypertrophic cardiomyopathy （HCM）by two dimensional speckle tracking imaging（2D -STI）. Methods Forty -six patients with HCM and thirty - two healthy volunteers were studied by 2D - STI. Two - dimensional echocardiography was performed to collect three consecu- tive cardiac cycles dynamic images of LV four - chamber view,two chamber view, apical long axis view. The peak longitudinal strain rate of early and late of diastole（SRe, SRa）at each segment of the LV basal,middle and apical levels were measured. The peak time of early and late diastolic longitudinal strain rate （TEs~, TAsK ） were measured from the start point of QRS wave of electrocardiogram. The LV segmen- tal standard deviation（ TESR - SD, TASR - SD） and maximal difference （TEsR - Diff,TAsrt - Diff） were calculated. Results Compared with normal controls,SRe of 17/18 segments and SRa of 6/18 segments were decreased in HCM group. TESR -SD, TAstl -SD and TESR -Diff were significantly higher in patients with HCM than in normal controls. TASR - Diff were higher in patients with HCM than in normal con-trois, but the difference had no statistical significance. Conclusion 2D - STI is a new non - invasive method that could accurately and quantitatively evaluate the LV diastolic function and synchrony with HCM.