二维应变参数评价扩张型心肌病患者左心室收缩同步性及其与心功能的关系

发布时间：2018-03-06 14:14

本文选题：超声检查　切入点：心肌病　出处：《中国医学影像技术》2017年09期 　论文类型：期刊论文

【摘要】：目的探讨二维斑点追踪成像(2D-STI)应变参数评价扩张型心肌病(DCM)患者左心室收缩同步性的价值及其与心功能的关系。方法收集DCM患者(DCM组)及对照组各25例,采用2D-STI技术获取左心室各节段纵向应变达峰时间、圆周应变达峰时间(Tls、Tcs),分别计算左心室18节段纵向应变达峰时间标准差(Tls-SD)及最大差值(Tls-dif),左心室心尖四腔心、三腔心、二腔心切面6节段纵向应变达峰时间标准差(Tls-SD-4、Tls-SD-3、Tls-SD-2)及最大差值(Tlsdif-4、Tls-dif-3、Tls-dif-2),左心室18节段圆周应变达峰时间标准差(Tcs-SD)及最大差值(Tcs-dif),左心室短轴二尖瓣、乳头肌、心尖水平6节段圆周应变达峰时间标准差(Tcs-SD-M、Tcs-SD-P、Tcs-SD-A)及最大差值(Tcs-dif-M、Tcs-dif-P、Tcsdif-A)。结果与对照组比较,DCM组整体及节段应变参数均显著增大(P均0.05);DCM组中,除Tcs-dif-P、Tcs-dif外,余应变参数均与左心室射血分数呈负相关(P均0.05);除Tcs-dif-M、Tcs-dif-P及Tcs-dif外,余应变参数均与舒张早期二尖瓣口峰值血流速度(E)/二尖瓣环运动速度(e)呈正相关(P均0.05)。结论 DCM患者左心室整体及局部收缩期应变均存在不同步,收缩不同步可加剧心功能的恶化;2D-STI参数可以客观评价DCM患者左心室收缩不同步及其与心功能的关系。
[Abstract]:Objective to evaluate the value of 2D-STI strain parameters in evaluating left ventricular systolic synchrony and its relationship with cardiac function in patients with dilated cardiomyopathy (DCM). Methods 25 cases of DCM and 25 cases of control group were collected. The longitudinal strain peak time and circumferential strain peak time of left ventricle were obtained by 2D-STI technique. The standard deviation of left ventricular longitudinal strain peak time (Tls-SDS) and maximum difference (Tls-difn), left ventricular apical four chamber heart, three chamber heart were calculated, respectively. Tls-SD-4n Tls-SD-3n Tls-SD-2), Tlsdif-4n Tls-dif-3 (Tls-dif-2n), Tcs-SDS (18 segments of left ventricular circumferential strain peak time standard deviation (Tcs-SDD), left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, left ventricular short axis mitral valve, papillary muscle, Tcs-SD-Mn Tcs-SD-PnTcs-SD-Aand the maximum value of Tcs-dif-M ~ (+) Tcs-dif-P ~ (+) Tcsdif-Tcsdif-An. Results compared with the control group, the total and segmental strain parameters of DCM group were significantly increased (P < 0.05), except Tcs-dif-P ~ (+) -Tcs-dif group, and the total and segmental strain parameters of DCM group were significantly higher than those of the control group (P < 0.05), with the exception of Tcs-dif-Pe Tcs-dif. The residual strain parameters were negatively correlated with left ventricular ejection fraction (P < 0.05), except for Tcs-dif-M (Tcs-dif-P) and Tcs-dif. There was a positive correlation between the parameters of residual strain and peak mitral flow velocity and mitral annular velocity (E) in early diastolic phase (P < 0.05). Conclusion the global and local systolic strain of left ventricle in DCM patients is out of sync. Systolic asynchrony can aggravate the deterioration of cardiac function. 2D-STI parameters can objectively evaluate the relationship between left ventricular systolic asynchrony and cardiac function in patients with DCM.
【作者单位】：武汉大学人民医院超声科;
【基金】：湖北省卫计委青年人才项目(WJ2015Q016)
【分类号】：R445.1;R542.2

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