斑点追踪成像评价急性心肌梗死及慢性缺血性心力衰竭患者左心室扭转

目的应用超声斑点追踪技术（STE）比较急性心肌梗死（AMI）及慢性缺血性心力衰竭（HF）患者左心室扭转和解旋的差异。方法采用STE测量48例AMI患者（AMI组）、45例HF患者（HF组）及50名正常人（NOR组）的左心室基底段及心尖段心肌旋转角度峰值（Ptwbase,Ptwapex）、左心室扭转角度峰值（Ptw）、左心室解旋率峰值（UntwR）、左心室扭转达峰时间（TPtw）及左心室解旋达峰时间（TPUR）。结果 AMI组及HF组患者的Ptwbase、Ptwapex、Ptw、UntwR均减低,HF组减低更明显（P〈0.01）,AMI组及HF组的TPtw早于NOR组（P〈0.01）;Ptw、Ptwapex与LVEF呈正相关（P均〈0.001）。结论左心室扭转与收缩功能显著相关,AMI及HF患者左心室扭转及解旋均显著减低,左心室收缩功能受损。STE可准确评价左心室功能。

Speckle tracking echocardiographic assessment on left ventricular twist in patients with acute myocardial infraction and chronic ischemia heart failure

Objective To evaluate the differences of left ventricular twist and untwisting rate in patients with acute myocardial infarction（AMI）and ischemic chronic heart failure（HF）with speckle tracking echocardiography（STE）.Methods Forty-eight patients with AMI（AMI group）,45 patients with HF（HF group）and 50 healthy subjects（NOR group）underwent two-dimensional strain echocardiography.Peak apical rotation（Ptw apex）,peak basal rotation（Ptw base）,peak left ventricular twist（Ptw）,peak left ventricular untwisting rate（Untw R）,time to peak left ventricular twist and untwisting rate（TPtw,TPUR）were measured and compared.Results Ptw base,Ptw apex and Untw R decreased in AMI group,and extremely decreased in HF group（P0.01）.TPtw in AMI group and HF group were earlier than that in NOR group.There was positive correlation between Ptw base,Ptw apex and left ventricular ejection fraction（P0.001）.Conclusion Left ventricular twist is strongly related to left ventricular systolic function.Impairment of left ventricular function in patients with AMI and HF is associated with decrease of impairment twist and untwist rate.STE may accurately evaluate left ventricular function.