应用定量组织速度及组织追踪成像评价心衰患者心肌不同步性

Evaluation of ventricular dyssynchrony using quantitative tissue velocity imaging and tissue tracking in patients with heart failure

目的探讨应用定量组织速度及组织追踪成像评价心衰患者左心室心肌收缩、舒张功能不同步性的可行性。方法选取26例心力衰竭患者及30例正常对照组,应用QTVI成像软件和TT分析软件,在心尖四腔心,取后间隔及侧壁基底段(B)和中段(M)心肌分别放置取样点,测量收缩期及舒张期的心肌运动速度及组织位移的达峰时间,计算相同节段不同室壁间及不同节段相同室壁间的时间差。结果与对照组比较,心衰组收缩期速度及组织位移的达峰时间明显延长,舒张早期速度达峰时间无显著差异性,舒张晚期速度达峰时间明显缩短,而收缩期及舒张期速度及组织位移的时间差明显延长。结论心力衰竭患者存在左心室收缩及舒张的不同步性,定量组织速度及组织追踪不失为早期、精确、无创、定量评价其不同步性的方法。

Objective To assess a new noninvasive index to identify systolic and diastolic dyssynchrony in patients with heart failure. Method Certain parameters from apical four-chamber view at the basal and mid left ventricular wall such as Q-wave-to-systolic velocity times, Q-wave-to-early diastolic velocity times, Q-wave-to-late diastolic velocity times and Q-wave-to-displacement times （Q-Vs, Q-VE, Q-VA , Q-Ds respectively ） were evaluated by means of quantitative tissue velocity imaging （QTVI） and tissue tracking in 26 patients with heart failure and 30 normal subjects. The time of the basal lateral and septal wall , the middle lateral and septal wall ,the basal and the middle lateral, the basal and middle septal （ΔQ-VS,AQ-VE,ΔQ-VA ,ΔQ-DS respectively） were calculated for each case. Results Compared with control group, most of the parameters in heart failure group were extended such as Q-Vs,Q-Ds ,ΔQ-Vs,ΔQ- VE,ΔQ-VE,ΔQ-Ds （P〈0.05, P〈0.01 ）.There were no significant differences in Q-VE base and middle wall level（P 〉 0.05）. There was decreased in Q-VA （P〈0.05, P〈0.01 ）. Conclusions There were left ventricular systolic and diastolic dyssynchrony in patients with heart failure. Quantitative tissue velocities and tissue tracking can early , veraciously, non-invasively and quantitatively provide the information for myocardial function in patients with heart failure.