应变率成像评价肥厚型心肌病患者左心室壁运动同步性

Evaluation of synchronism of left ventricular in patients with hypertrophic cardiomyopathy by strain rate imaging

目的探讨运用应变率成像技术评价HCM患者左心室心肌运动同步性的价值。方法HCM患者21例,根据室间隔及左心室壁厚度分3组:非肥厚组(NH),室壁厚度(WT)≤11mm,101节段;轻度肥厚组(MH),11mm<室壁厚度(WT)≤15mm,86节段;重度肥厚组(SH),室壁厚度(WT)≥16mm,65节段。对照组18例,216节段。获取各受试者心尖四腔观、左心室长轴及两腔观TVI图像存盘,供脱机分析。测量参数TSSR、TESR、TSSR-SD、TESR-SD、ΔTSSR、ΔTESR、CVTSSR及CVTESR。结果与对照组室壁节段比较,HCM组MH和SH亚组TSSR、TESR均显著延长;与对照组比较,HCM组NH组TSSR无显著差异,TESR则显著延长;HCM组NH、MH、SH亚组之间比较,TSSR、TESR依次延长,即NH<MH<SH;与对照组比较,HCM组TSSR-SD、TESR-SD、ΔTSSR、ΔTESR、CVTSSR和CVTESR均显著增大。结论HCM患者左心室局部收缩、舒张早期电-机械时间均延迟;HCM患者左心室收缩、舒张运动存在不同步现象,应变率成像技术能准确评价其左心室运动不同步。

Objective To assess the value of strain rate imaging （SRI） in detecting synchronism of left ventricular in patients with hypertrophic cardiomyopathy （HCM）. Methods Twenty-one patients with HCM were divided into 3 groups according to the thicknesses interventricular septum and left ventricular wall., tissue velocity imaging of all patients and controls were accepted in apical four, long axis or two chamber views, indices including TSSR, TESR TSSR-SD, TESR-SD, ATssR, △TESk, CVTssR and CVTESR. Results Compared with controls, TssR and TESR of MH and SH of HCM delayed significantly, while TESR of NH delayed significantly. TSSR and TESR in three groups of HCM delayed （NH〈MH〈SH）. Compared with the controls, TSSR-SD, TESR-SD, △TSR, △TESR, CVTssR and CVTESR in patients with HCM increased significantly. Conclusion The regional electro-machine time in systole and early diastole Of patients with HCM represents delay, indicating that systolic and diastolic asynchronization of left ventricular exists in HCM and can be evaluated accurately by SRI.