心力衰竭患儿左右心室间非同步运动的超声心动图评价

Evaluation interventricular asynchrony between LV and RV in children with congestive heart failure by echocardiography

目的:探讨2种超声心动图方法对心力衰竭(CHF)患儿左右心室间非同步运动的评定价值。方法:选取正常小儿40例,CHF患儿30例。①在组织多普勒状态下获取标准心尖四腔观及两腔观,应用QTVI技术描记左心室各壁基底段及右心室侧壁基底段心肌的组织多普勒速度曲线,测量每一取样点心肌运动曲线上自QRS波起始至收缩期峰值的心肌电-机械收缩时间(ts),计算右室侧壁基底段ts值、左室基底段ts均值及二者差值Δts。②脉冲多普勒状态下,测量QRS起点到主动脉瓣血流频谱起点时间(t(LPEP))、QRS起点到肺动脉瓣血流频谱起点时间(t(RPEP))及其差值(Δt(PEP))。结果:CHF患儿左右心室间存在有明显的收缩不同步。CHF组2种检测方法测定的6项指标中除Δts较对照组显著减小外,其余指标均明显大于对照组,差异有统计学意义(P<0.05),且Δt(PEP)与左室射血分数呈负相关(r=-0.31,P<0.05)。结论:脉冲多普勒对评价儿童CHF有较高的应用价值。

Aim： To evaluate two methods of echocardiography in Interventricular asynchrony between LV and RV in the children with congestive heart failure（CHF）. Methods：Quantitative tissue velocity imaging （QTVI） was performed in 40 normal children and 30 children with CHF using apical four-chamber view and two- chamber view. The time from onset of QRS complexes to peak velocity during systole（ts） was measured in myocardial movement curves of every segments, t （RV） and t（LV） and their difference（△ts） were measured respectively. 40 normal children and 30 children with C HF were studied by PW-Doppler： The time from onset of QRS complexes to beginning times of flow velocity spectra in aortic valve （t （LPEP）） and pulmonary valve （t（RPEP） ） and their difference（ △t（PEP） ） were measured respectively. ResUlts： The interventricular asynchrony exists in children with CHF. All indexes in two methods, except Ats were lower than those in control group, the other were significant prolonged compared with control group. △t （PEP） was negative correlated with LVEF （ r = - 0.31, P 〈 0.05 ）. Conclusion ： PW-Doppler has higher value in diagnosis of children with CHF.