组织速度成像评价慢性心衰左室心肌纵轴速度变化

Quantitative Tissue Velocity Imaging to Assess the Changes of Left Ventricular Myocardial Longitudinal Axis Velocity in Children with Chronic Heart Failure

目的探讨定量组织速度成像技术(QTVI)评价慢性心力衰竭(CHF)左室心肌纵轴速度变化。方法应用QTVI测量35例小儿CHF患者和30例正常儿童于标准心尖四腔、两腔及心尖长轴切面获得的左心室6个室壁(后间隔、侧壁、前壁、前间隔、后壁)基底段、中间段及心尖段长轴方向收缩期心肌运动速度(Vs)。计算各室壁心肌相邻阶段间的速度差(△V1=基底段速度-中间段速度、△V2=中间段速度-心尖段速度)。结果正常组左室各室壁间心肌运动速度不同,其中侧壁速度最高。而6个室间壁△V1、△V2无明显差异。CHF患者左心室各室壁各节段心肌Vs及各室壁△V1、△V2明显降低,与对照组比较差异有显著性(P<0.05)。CHF组各室壁间△V1、△V2无差异,将CHF组左室后间隔△V1、△V2与LVEF值进行相关性分析,二者呈正相关。结论CHF患者左心室长轴方向各个室壁心肌节段收缩期心肌运动速度及速度差明显降低,速度差与LVEF具有明显相关性。各室壁同水平速度差无差异,利用速度差评价心功能时仅测量某一定壁的心肌速度差即可。

Objective To study the application of quantiative issue velocity imaging（QTVI） in the assessment of the changes of left ventricular myocardial longitudinal axis veioctiy in children with chronic heart failure（CHF）. Methods QTVI was used to assess 35 children with CHF and 30 controls systolic velocity of basal, mid, and apex segments of 6 ventricular walls in the long axis direction from standard apical fourchamber, two -chamber and apex long axis views to calculate the difference between neighbored myocardial segments of each ventricular wall（ △ V1 = velocity at basal segment -velocity at mid segment, △ V2 = velocity at mid segment - velocity at apex segment）. Results In controis, the moving velocities in the ventricular walls were different, with the highest at lateral wall. There was no significant difference in △V1 and △V2, CHF patients Vs △V1 and △V2 decreased obviously, there was signifgcant difference compared with that of controls （ P 〈 0.05 ）. And the△ V1 and△ V2 of posterior left interventricular septum of left was positively related to LVEF. Conclusion The longitudinal axis systolic velocity and velocity difference of the myocardial segments of all left ventricular walls are significantly lower in patients with chronic heart failure. And the velocity difference is obviously related to LVEF. There is no difference in velocity at the same level in ventricular walls, It is e-ough to measure velocity of only one of the ventricular walls to evaluate the heart function with velocity difference.