心力衰竭患者左心功能与心肌非同步运动的关系

Echocardiography study on the correlation between left ventricular asynchronicity and left heart function

目的:探讨心力衰竭患者(CHF)左心功能与心肌非同步运动的关系。方法:应用超声心动图取标准心尖位左室长轴观、两腔观和四腔观,获得正常人和CHF患者各30例左心室18个节段的定量组织速度成像(QTVI)曲线,测量各节段自QRS波起始至心肌收缩期峰值速度和舒张早期峰值速度的时限Ts和Te,并计算反映左心室非同步运动程度的指标,即18个心肌节段Ts和Te的最大差值(Δtsmax和Δtemax);心功能指标包括左心室射血分数(LVEF)和Tei指数。结果:CHF组Δtsmax和Δtemax较正常组延长,差异有统计学意义(P<0.05);CHF组Δtsmax和Δtemax与LVEF呈负相关(r=-0.75与-0.63,P均<0.05),与Tei指数呈正相关(r=0.61和0.70,P均<0.05)。结论:CHF患者左心室存在非同步收缩与舒张,可对左心功能产生影响。

Aim ： To study the correlation between left ventricular asynchronicity and left heart function in patients with congestive heart failure（CHF）. Methods：Quantitative tissue velocity imaging curves of 18 segments were got in 30 cases of CHF and 30 health controls from standard long-axis, two-chamber, and four-chamber view. Ts and Te of each segment （from QRS to the peak systolic flow velocity and early diastolic flow velocity） were measured. Indexes reflecting the degrees of left ventrieular asynchronicity were calculated, which was the maximal differences of Ts and Te （ △tsmax and △temax ） in 18 myocardial segments. LV ejection fraction （LVEF） , and Tel index were obtained too. Results： At and At were obviously prolonged in CHF group than those in controls （ P 〈 0. 05）. In CHF group, △tsmax and △temax were negatively correlated with LVEF （r= -0.75 and -0.63,P〈0.05）and positively correlated with Tel index（r=0.61 and 0.70,P〈 0.05）. Conclusion ： There is left ventricular systolic and diastolic asynchronicity in the patients with CHF. Asynchronicity is closely related with left heart function.