急性心肌梗死的左室短轴心肌地形图分析

Application of circumferencial myocardial function maps of tissue Doppler in patients with acute myocardial infarction

目的研制组织多普勒(TDI)短轴心肌功能地形图(CFM),并初步评价该CFM分析系统定量分析冠心病心肌节段运动的作用。方法用普通彩色超声仪器采集含急性心肌梗死(AMI)患者在内的冠心病人(59例)的左室短轴心肌TDI图像,冠心病组分为AMI亚组(23例)与②冠心病亚组(36例)。自制CFM技术从左乳头肌起,以0°至360°方式表示左室短轴心肌的空间分布,用心内膜面的运动幅度与速度来描述节段运动。结果心梗区心肌的CFM节段运动曲线急剧向零线方向移动,可以用CFM圆形图像上低平线段所占度数来定量描述缺血心肌的分布范围,AMI亚组异常节段的分布范围较冠心病亚组增大,具有统计学上显著性差异[(75.64±37.56)°vs(33.44±11.81)°,P<0.001]。结论自制CFM技术能够用于定量分析AMI的心肌节段运动,该技术增加了组织多普勒技术分析心肌节段运动的能力。

Objective A circumferencial functional map （CFM） of tissue Doppler imaging （TDI） was applied in patients with coronary artery disease （CAD） and the accuracy of CFM in assessment of ischemic region in patients with acute myocardial infarction （AMI） was evaluated. Methods CFM was performed in 59 patients with CAD and 26 subjects as control. Patients with CAD were divided into subgroups of AMI （n=23） and myocadial ischemia （n= 36）. The spatial distribution of hypokinetic motion of endocardium could be demonstrated by CFM in which left papillary muslue was considered as the beginning point and the measurement was made from 0° to 360° on CFM. Results The curve of endocardial motion in patients with AMI was shifted towards zero line on CFM and the extent of wall motion abnormality would be described quantitatively. The extent of abnormal segments in AMI was broader than that in myocadial ischemia subgroup （[-75.64 ±37.56]° vs [33. 44±11. 81]°, P〈0. 001）. Conclusion CFM at the midpapillary muscle level could be used in detection of hypokinetic segments, which might increase the ability of TDI in assessing coronary artery disease.