二维斑点追踪技术对扩张型心肌病及缺血性心脏病患者右心房功能的研究

Evaluation of right atrial function in patients with dilated cardiomyopathy and ischemic cardiomyopathy using two-dimensional speckle tracking imaging

目的应用二维斑点追踪（2D_sTI）技术测量原发性扩张型心肌病（IDCM）及缺血性心脏病（ICM）患者右心房心肌应变，以评价其在右心功能改变中的临床应用价值。方法选取31例IDCM患者，30例ICM患者及30例健康对照者，采集高频二维动态图像，脱机应用软件测量右心房整体纵向应变值（GLS）。结果与对照组相比，IDCM组和ICM组左室射血分数（LVEF）、三尖瓣环位移（TAPSE）、右室面积变化分数（RVFAC）、右室缩短率（RVFS）、三尖瓣环收缩期峰值（S’）均减低（P〈0．05），右室心肌做功指数（MPI）增大（P〈0．05），两病例组间差异无统计学意义（P〉0．05）；IDCM组和ICM组GLS减低（P〈0．001），两病例组间差异有统计学意义（P〈0．001）。GLS与TAPSE、MPI具有显著相关性。结论2D-STI技术测量右房应变能定量评估IDCM和ICM患者的右心功能受损情况。

Objective To evaluate right atrial function in patients with idiopathic dilated cardiomyopathy （IDCM） arid ischemic cardiomyopathy （ICM） by using two-dimensional speckle tracking imaging （2D-STI）. Methods Study population consisted of 31 patients with IDCM,30 with ICM and 30 healthy subjects. High frame rate two-dimensional images were recorded from the apical four chamber view. Right atrial global longitudinal strain （GLS） was measured using two-dimensional strain soft ware. Results Compared with the controls, left ventrieular ejection fraction （LVEF）, tricuspid annular plane systolic excursion （TAPSE）, right ventricular fractional area change （RVFAC）, right ventricular fractional shortening （RVFS） and tricuspid annular peak systolic velocity（S＇） decreased （P 〈0.05）, while right ventricular myocardial performance index （MPI） increased in IDCM and ICM group. There were no significant differences for all above echocardiographic parameters between IDCM and ICM patients. Compared with the controls,right atrial GLS decreased significantly in patients with IDCM and ICM, even much lower in patients with IDCM （ P 〈0.00l）. Conclusions Measurement of right atrial strain using 2D- STI could be used for the assessment of right atrial dysfunction in patients with ICDM and ICM.