斑点追踪显像技术初步评价二尖瓣机械瓣置换术后患者左室旋转和扭转运动

发布时间：2018-11-25 07:59

【摘要】：目的： 利用斑点追踪显像技术初步评价二尖瓣机械瓣置换术后患者左室心肌内、外膜的扭转和旋转运动。 方法： 选择二尖瓣机械瓣置换术后(包含双瓣置换术后)患者21例和正常对照组25例。应用斑点追踪显像技术测定左室短轴切面基底段和心尖段心肌内、外膜及整体的收缩期最大旋转角度,同时计算整个左室内、外膜及整体的最大扭转角度,并在两组之间进行对比。将瓣膜置换组左室心肌内、外膜及整体的旋转和扭转角度与左室射血分数、舒张末期左室内径及左房内径的进行相关性分析,并将瓣膜置换组按手术术式、术后时间和左室射血分数水平进行分组分析。 结果： 1.对比对照组,瓣膜置换术组左心射血分数明显降低(P=0.002)；收缩期心尖水平内膜(P=0.010)旋转角度减少,外膜(P=0.003)及整体(P=0.004)旋转角度明显减少,收缩期左室内膜(P=0.006)、外膜(P=0.002)及整体(P=0.002)扭转角度明显减少,而基底水平旋转角度无统计学意义(P0.05)。 2.瓣膜置换组收缩期基底水平和心尖水平的心肌外膜及整体旋转角度与LVEF呈中度相关,左室扭转角度与LVEF呈中度相关；收缩期心尖段旋转角度及左室扭转角度与LVDd呈中度相关。 3.瓣膜置换组内比较：LVEF60%组较LVEF≥60%组其收缩期心肌内、外膜及整体扭转角均明显减低(P0.01)。 结论： 二尖瓣机械瓣置换术后患者较正常人左室射血分数减低,并存在左室旋转及扭转运动损害,心尖段旋转运动及左心扭转运动受损明显,其中外膜旋转和扭转运动受损程度较明显,基底段旋转运动受损不明显。左室旋转和扭转运动影响LVEF水平,其中外膜的旋转和扭转运动与LVEF相关性最好。心功能损害其心内、外膜和整体扭转运动均受损。
[Abstract]:Objective: to evaluate the torsion and rotation of left ventricular adventitia after mitral valve replacement by speckle tracing imaging. Methods: 21 patients after mitral mechanical valve replacement (including double valve replacement) and 25 normal control group were selected. The maximal systolic rotation angles of the basal and apical segments of the left ventricular short axis were measured by speckle tracing imaging, and the maximal torsion angles of the whole left ventricle, the epineurium and the whole heart were calculated. A comparison was made between the two groups. The relationship between left ventricular ejection fraction (LVEF), left ventricular end-diastolic diameter (LVEH) and left atrial diameter (LVAD) in the valve replacement group was analyzed by the rotation and torsion angles of the left ventricular myocardium, adventitia and the whole body, and the valve replacement group was operated on. Time after operation and left ventricular ejection fraction (LVEF) were analyzed in groups. Results: 1. Compared with the control group, the left ventricular ejection fraction (LVEF) in the valvular replacement group was significantly decreased (P0. 002). The rotation angle of the lateral intima (P0. 010) was decreased, the rotation angle of the adventitia (P0. 003) and the whole (P0. 004) was decreased, and the left ventricular intima (P0. 006) in the systolic phase. The torsion angle of the outer membrane (P0. 002) and the whole (P0. 002) decreased significantly, but the horizontal rotation angle of the substrate was not statistically significant (P0.05). 2. In valvular replacement group, the myocardial epicardial and global rotation angle of systolic basal level and apical level were moderately correlated with LVEF, and the angle of left ventricular torsion was moderately correlated with LVEF, and the rotation angle of systolic apical segment and left ventricular torsion angle were moderately correlated with LVDd. 3. Compared with LVEF 鈮，

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