三维斑点追踪技术评价心脏再同步化治疗患者心肌力学的特征

发布时间：2018-03-15 06:25

本文选题：三维斑点追踪技术　切入点：心脏再同步化治疗　出处：《中国超声医学杂志》2017年08期 　论文类型：期刊论文

【摘要】：目的应用三维斑点追踪技术(3D-STI)评价心脏再同步化治疗(CRT)前后患者的心肌力学特征。方法获取53例CRT患者左室环向、纵向及径向应变(CS、LS、RS)来评估左室心肌收缩力;测量并计算左室16节段环向、纵向及径向应变达峰时间标准差(Tcs-16SD、Tls-16SD、Trs-16SD)来评估左室机械同步性。结果 (1)CRT术前,CRT有效组左室心肌收缩力较无效组强,机械同步性较无效组差(P0.05);(2)CRT术后,CRT有效组心肌收缩力及机械同步性均显著改善;CRT无效组心肌收缩力较术前改善(P0.05),机械同步性与术前相比无明显差异(P0.05);(3)在3D-STI指标中,Tls-16SD预测CRT术后疗效最有价值;(4)三维容积及心肌力学指标在观察者内、观察者间有较好的一致性。结论 CRT既能改善左室机械同步性,也能改善左室心肌收缩力,Tls-16SD能够有效地预测CRT疗效。
[Abstract]:Objective to evaluate the myocardial mechanical characteristics of 53 patients with CRT before and after cardiac resynchronization therapy by using 3D dot tracing technique. Methods left ventricular contractility was evaluated in 53 patients with CRT. To evaluate left ventricular mechanical synchrony, left ventricular mechanical synchrony was evaluated by measuring and calculating the standard deviation of peak time of 16 segments of left ventricular strain (Tcs-16SDN, Tls-16SD-Trs-16SD). Results the contractility of left ventricular myocardium was stronger in the effective group before CRT than in the group with no response to CRT. Mechanical synchrony was worse than that of ineffective group (P 0.05). The myocardial contractility and mechanical synchronism in the effective CRT group were significantly improved compared with that in the preoperative group. There was no significant difference in mechanical synchrony between the two groups (P0.05 / 16SD) in the 3D-STI index. The most valuable predictor of the outcome of CRT was the three-dimensional volume and myocardial mechanical parameters in the observer. Conclusion CRT can not only improve the mechanical synchronism of left ventricle, but also improve the contractility of left ventricular myocardium. Tls-16SD can effectively predict the effect of CRT.
【作者单位】：上海市影像医学研究所复旦大学附属中山医院心脏超声诊断科上海市心血管病研究所;
【基金】：国家自然科学基金(No.81371576,81671685) 上海市卫计委面上项目(No.201440538)
【分类号】：R445.1;R54

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