斑点追踪技术评价肥厚性心肌病左室收缩功能

Assessment of Left Ventricular Systolic Function in Hypertrophic Cardiomyopathy Using Speckle Tracking Imaging

目的探讨斑点追踪技术(STI)评价肥厚性心肌病(HCM)患者左室心肌收缩功能的价值。资料与方法选择无左室流出道梗阻、无明显临床症状、尚未接受临床干预性治疗的31例室间隔中上部肥厚性心肌病患者,同时采用随机数字表法选择30例健康成人作为对照组,采用Philips iE33彩色多普勒超声诊断仪,连接心电图,X3-1探头于心尖四腔切面采集实时三维超声图像,测量各组左室射血分数(LVEF);S5-1探头于短轴切面乳头肌水平采集二维灰阶图像,利用斑点追踪技术测量中段前间隔和间隔的局部收缩功能参数:心肌运动速率(S)、环向应变率(CSR)、径向应变率(RSR)、角速度(AV)、角位移(AE),测量该层面整体旋转角度峰值(BR)。对两组间各参数进行比较。结果 HCM组与对照组LVEF比较,差异无统计学意义(P>0.05)。与对照组比较,HCM组中段前间隔与间隔的S、CSR、RSR、AV减低,BR增加,AE增加,差异均有统计学意义(P<0.05)。结论斑点追踪技术能够无创、准确地评价肥厚性心肌病患者的局部心肌功能,为临床早期诊治提供有价值的信息。

Purpose To evaluate left ventricular systolic function of patients with hypertrophic cardiomyopathy （HCM） using speckle tracking imaging.Materials and Methods Thirty-one asymptomatic HCM patients with upper interventricular septum hypertrophy,but no left ventricular outflow obstruction was selected as HCM group before treatment.Thirty health persons were selected at random as control group.Left ventricular ejection fraction （LVEF） was detected by X3-1 probe at 4 chamber apex view using real time three-dimensional echocardiography.Regional systolic function parameters,including speed （S）,circumferential strain rate （CSR）,radial strain rate （RSR）,angle velocity （AV）,angle excursion （AE）,and bulk rotation （BR）,were detected by S5-1 probe at short axis view papillary muscle level using speckle tracking imaging.Results There was no significant difference between HCM group and control group in LVEF （P 0.05）.Significant differences were detected between the two groups with decreased S,CSR,RSR,AV and increased BR and AE in HCM group （P0.05）.Conclusion Speckle tracking imaging can evaluate regional myocardial function in patients with hypertrophic cardiomyopathy noninvasively and accurately,so that it can provide valuable information for earlier clinical diagnosis and treatment.