速度向量成像比较慢性心力衰竭患者左心室切向和轴向运动

Comparative study of tangential and radial movement of left ventricle in patients with chronic heart failure by vector velocity imaging echocardiography

目的通过对慢性心力衰竭(CHF)患者心脏运动特点进行斑点成像分析,探讨这一新技术在全面评估心功能中的临床应用价值。方法对我科2006年9月至11月收治的29例CHF患者进行速度向量成像超声心动图检查,测量左心室6个基底节段、6个中间节段共12个节段切线方向和轴向方向的峰值速度(Sv)和达峰时间(Ts-Sv),并计算12个节段达峰时间的标准差(Ts-SDv)。结果无论是切向运动还是轴向运动,左心室整体运动基底段室壁运动速度显著高于中段[切向:(1．37±0．72)m／s比(0．89±0．47)m／s,P<0．01;轴向: (1．28±0．57)m／s比(0．92±0．49)m／s,P<0．01],而两者Ts-Sv的差异无统计学意义(P>0．05)。切向与轴向运动的Ts-Sv平均值呈显著正相关(r=0．53,P=0．001),两者具有较好的一致性(SD=52 ms,95％CI为-94～107 ms)。12个节段切向与轴向Ts-SDv的差异无统计学意义[切向为(79±70)ms,轴向为(81±18)ms, P=0．868]。结论CHF患者的切向与轴向运动Sv具有良好的相关性。

Objective To appraise the clinical value of new echocardiographic technique, vector velocity imaging, by analyzing the characteristics of left ventricle movement. Methods Twenty-nine patients with chronic heart failure from september to november 2006 underwent vector velocity echocardiography. The tangential and radial peak velocities and time-to-peak velocity were measured at 6 basal segments and 6 mid segments of left ven- tricle, and the standard deviation of time-to-peak velocity of 12 segments were calculated. Results Both the tangential [（1. 37±0.72） m/s vs （0. 89 ± 0. 47） m/s, P 〈 0. 01J and radial [（1. 28 ± 0. 57） m/s vs （0. 92 ± 0.49） m/s, P〈0.01] movements of left ventricle had same trend in left ventricular global movement. The peak velocities of basal segments moved faster than those of mid segments, but the time-to-peak velocity showed no difference. Tangential time-to-peak velocity was relatively significant with radial time-to-peak velocity （r = 0.53, P = 0. 001）, and with high correlation by Bland-Airman analysis （SD = 52 ms, 95% CI- 94-107 ms）. Ts-SDv was not different among the 12 segments [（79 ± 70） ms vs （81 ± 18） ms, P = 0. 8681. Conclusions Good correlation can be seen in tangential and radial peak velocity in patients with CHF.