组织运动二尖瓣环位移自动追踪技术评价充血性心力衰竭患者左心室收缩功能

Quantitative evaluation of left ventricular systolic function with automated motion tracking of mitral annular displacement in patients with heart failure

目的探讨定量组织运动二尖瓣环位移技术(TMAD)对充血性心力衰竭患者(CHF)左心室收缩功能的评价作用。方法左心衰患者和健康志愿者各40例,二维测量左心室舒张末期内径(LVEDd)、舒张末期容积(LVEDV)、收缩末期容积(LVESV)和射血分数(LVEF)。使用TMAD技术,测量二尖瓣环6个位点的收缩期最大位移(Ds)、最大位移达峰时间,并将平均Ds与简化双平面Simpson法计算出的左心室射血分数(LVEF)进行相关分析。结果与对照组相比,HF组的LVEDd、LVEDV、LVESV均显著增加(P<0.01),LVEF显著减低(P<0.01)。HF组二尖瓣环6个位点DS比正常组显著减低,差异有统计学意义(P<0.01)。HF组二尖瓣环6个位点DS的达峰时间与正常对照组相比显著增加(P<0.01)。正常组二尖瓣环6个位点平均Ds与LVEF呈显著正相关(r=0.853,P<0.01),HF组二尖瓣环6个位点平均Ds与LVEF呈正相关,但较正常组低(r=0.419,P<0.05)。结论TMAD作为一种新技术成为简单、准确、客观地评价心力衰竭患者左心室收缩功能的新途径。

Objective To observe the value of tissue motion tracking of mitral annular displacement （TMAD） method in the assessment of left ventricular systolic function in patients with congestive heart failure （CHF）. Methods Forty patients with CHF and forty healthy subjects were enrolled in this study. Left ventricular end-diastolic dimension （LVEDd）, left ventricular end-systolic volume （LVESV）, left ventricular end diastolic volume （LVEDV） and left ventricular ejection fraction （LVEF） were measured with two-dimensional echocardiography. The maximal displacement of the six points of mitral annulus （DS） was measured with TMAD, and the correlation between mean displacement and LVEF was analyzed. Results Compared with healthy subjects, the LVDd, LVESV and LVEDV increased significantly （P〈0.01）, and the LVEF decreased significantly （P〈0.01） in the CHF group. The Ds of the six points of mitral annulus were significantly lower in the CHF than those in the health group （P,0.01）. Compared with healthy subjects, the displacement of the six points of mitral annulus decreased significantly （P〈0.01）, and the time to peak systolic displacement increased significantly （P〈0.01） in the CHF group. TMAD correlated well with biplane EF in the normal group （r=0. 853, P〈0.01） and also correlated with biplane EF in the CHF group （r=0. 419, P〈0.05）. Conclusion TMAD is a new technology to evaluate global I.V systolic function.