组织运动二尖瓣环位移自动追踪技术对扩张型心肌病左心室收缩功能的评价

Assessment of left ventricular systolic function in patients with dilated cardiomyopathy by automated motion tracking of mitral annular displacement

目的探讨组织运动二尖瓣环位移自动追踪技术(TMAD)评价扩张型心肌病患者左心室收缩功能的临床应用价值。方法选择30例扩张型心肌病患者及20例正常人,应用二维超声测量其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),应用TMAD技术测量二尖瓣环6个位点的收缩期最大位移(Ds),并将平均位移与简化双平面Simpson法计算的LVEF进行相关分析。结果扩张型心肌病患者与正常组相比,LVEDd、LV-EDV、LVESV均显著增加(P<0.001),LVEF显著减低(P<0.001);二尖瓣环6个位点Ds比正常组明显减低,差异有统计学意义(P<0.001)。正常人及扩张型心肌病患者二尖瓣环6个位点平均Ds与简化双平面Simpson法计算的LVEF呈显著正相关(r=0.878,0.687,均P<0.001)。结论TMAD技术可以定量评价扩张型心肌病患者左心室收缩功能,可作为临床评价左心室收缩功能的一种新方法。

Objective To explore the clinical value of automated motion tracking of mitral annular displacement for assessing left ven- tricular systolic function in patients with dilated cardiomyopathy （DCM）. Methods Left ventricular end-diastolic dimension （LVEDd） ,left ventricular end-diastolic volume （LVEDV）, left ventricular end-systolic volume （LVESV）and left ventricular ejection fraction（LVEF） were measured with two-dimensional echocardiography in 30 patients with DCM and 20 healthy controls. The maximal displacement of six points of mitral annulus（ Ds）was measured with TMAD,and the correlation between mean displacement（ MDs）and LVEF was analyzed. Results Compared with healthy controls,LVEDd,LVEDV,LVESV increased significantly in DCM patients（P 〈 0. 001 ）, and LVEF decreased significantly （ P 〈 O. 001 ）. The displacement of six points of mitral annulus was lower in DCM patients than those in healthy controls（ P 〈 0. 001 ）. TMAD was positively correlated with Simpson＇ s LVEF in healthy controls and DCM patients （r=0. 878,0. 687, P 〈 0. 001 ）. Conclusion TMAD can assess the left ventricular systolic function in patients with DCM, and it could be a new method for clinically evaluating the left ventricular systolic function.