应变和应变率成像评价肥厚型心肌病左室局部心肌收缩和舒张功能的研究

Research on left ventricular regional myocardial systolic and diastolic function in patients with hypertrophic cardiomyopathy by strain and strain rate imaging

目的:应用应变成像(SI)和应变率成像(SRI)评价肥厚型心肌病(HCM)患者左心室局部心肌收缩和舒张功能。方法:应用SI和SRI技术对34例HCM患者和24例正常人进行检测,获取左室各壁长轴方向基底段、中间段心肌应变和应变率曲线,测量各节段收缩期峰值应变(S)、收缩期峰值应变率(SRs)、舒张早期应变率(SRe)、舒张晚期应变率(SRa)。结果:与正常对照组比较,HCM组左室各节段收缩期峰值应变(S)、收缩期峰值应变率(SRs)、舒张早期应变率(SRe)均明显降低(P<0.05),左室大部分节段舒张晚期应变率SRa差异无显著性(P>0.05)。正常对照组约20%节段出现收缩期后缩短(PSS),HCM组约43%节段出现PSS,差异有显著性(P<0.05)。结论:SI和SRI可敏感地检出HCM患者左室局部心肌收缩和舒张功能的异常,是准确定量评价局部心肌收缩和舒张功能的一种新方法。

Objective： To evaluate the left ventricular regional myocardial systolic and diastolic function in patients with hypertrophic cardiomyopathy （HCM） by strain imaging （SI） and strain rate imaging （SRI）. Methods： SI and SRI were respectively performed on HCM patients with primary septal hypertrophy （HCM group,n=34） and control group （r=24） at apical long axis, two-chamber and four-chamber views. Sample volume was placed at myocardium under endocardium, and obtained synchronous S and SR curves （longitudinal axis）. Left ventricular regional systolic peak strain （S）, systolic peak strain rate （SRs）, early diastelic strain rate （SRe） and later diastolic strain rate （SRa） were measured and compared between HCM patients and normal subjects. PSS segment numbers were counted and compared between HCM patients and normal subjects. Results： The parameters of S, SRs, SRe in the HCM group were significantly lower than those in normal subjects （P〈0.05）; but compared with normal subjects, majority of SRa in HCM were not different. PSS present in 20% segments of the control group and 43% segments of HCM group. Conclusion： Strain and strain rate imaging can accurately evaluate regional myocardial systolic and diastolic function in patients with hypertrophic cardiomyopathy.