定量组织速度成像评价心力衰竭患者左心室非同步收缩运动与左心收缩功能关系

Evaluate the relationship between left ventricular systolic asynchrony and systolic function using tissue doppler imaging in heart failure patients

目的应用定量组织速度成像技术评价心力衰竭患者左心室心肌不同步收缩运动与左心收缩功能(LVEF)的关系。方法58例心衰患者分为QRS<120ms组(41例)和QRS≥120ms组(17例),正常对照组20例,进行多普勒组织速度超声心动图检测,以心电图Q波为起点,测量其到心肌6个壁12节段收缩期最大速度时间间期(Ts),进行对比分析,计算同一水平6个壁间Ts最大差值(Inter-ΔTs)、同一壁内2个节段间Ts最大差值(Intra-ΔTs)及左心室12个位点间Ts的最大差值(Max-ΔTs)。结果与正常对照组相比,两组心衰患者中Inter-ΔTs、Intra-ΔTs、Max-ΔTs均明显延长;而两组心衰患者中Inter-ΔTs、Intra-ΔTs、Max-ΔTs无明显不同。两组心衰患者中,Max-ΔTs与LVEF均呈负相关,而与QRS间期无关。结论心衰患者左心室同一水平不同节段、同一壁内均存在非同步运动,并且其与左室收缩功能呈负相关;左室心肌非同步收缩运动可在一定程度上反映左心室收缩功能。

Objective To study the relationship between left ventficular systolic asynchrony motion and left ventricular function in patients with heart failure. Methods Tissue doppler imaging was performed in 58 patients with heart failure and 20 normal healthy volunteers based on the six-basal and six-mid-segment model by apical view. Of these,41 patients had QRS duration 〈 120ms while 17 were prolonged （QRS ≥ 120 ms）. The regional parameters were measured off line, including the time from the beginning of QRS to the peak velocities. Assessments were performed between asynchrony motions and QRS duration and left ventricular function. Results Patients with heart failure had significant prolonged time to the peak velocities compared with normal controls. The maximal difference between the time to peak sustained systolic velocities correlated with low left ventricular ejection fraction and peak sustained systolic velocity in a univariate mode. Conclusion LV asynchrony motion is common in different sections with the same level and in the same section with heart failure patients. The degree of asynchrony motion correlates with low left ventficular function. So LV mechanical asynchrony can reflect LV systolic function in some degree.