组织运动二尖瓣环位移自动追踪技术对心脏再同步化治疗短期疗效的评价

Quantitative evaluation of short-term effect of cardiac resynchronization therapy by automated motion tracking of mitral annular displacement

目的探讨定量组织运动二尖瓣环位移技术（TMAD）对心脏再同步化治疗（CRT）患者短期疗效的评价作用。方法使用TMAD技术测量26例慢性充血性心力衰竭（CHF）患者CRT前和CRT1个月后左室壁二尖瓣环6个位点的收缩期最大位移（Ds）、二尖瓣环6个位点达峰时间的标准差（Tdsd）以及任意两位点收缩期最大位移达峰时间的最大差值（Tdsdiff），并将平均Ds与简化双平面Simpson法计算的左室射血分数（I。VEF）、左室收缩末容积（LVESV）及左室面积变化分数（FAC）进行相关分析。结果CRT1个月后二尖瓣环6个位点Ds及平均Ds比CRT前显著增高，差异有统计学意义（P〈0．01）；Tdsdiff较CRT前减少，差异有统计学意义（P〈0．05）；二尖瓣环6个位点Td—sd较CRT前减少，差异有统计学意义（P〈0．05）；二尖瓣环6个位点平均Ds与LVEF、LVESV、FAC呈正相关（r分别为0．419，0．529，0．567，P〈0．05）。结论TMAD可以用来评价CRT患者的短期疗效。

Objective To evaluate the tissue motion tracking of mitral annular displacement（TMAD） method in the assessment of short-term effect of cardiac resynchronization therapy （CRT）. Methods Twenty six chronic heart failure （CHF） patients with CRT were detected by TMAD. The maximal displacement of the six points of mitral annulus（DS）,the standard deviation of the time to regional peak systolic displacement of the six points （Td-sd） and the maximal temporal difference of any two points（Tds dill） were compared before and one month after CRT. And the correlation between mean displacement and left ventricular ejection fraction（LVEF）,left ventricular end systolic volume（LVESV）, fraction area change （FAC） was analyzed. Results Compared with the pre-operatively, the displacement and the mean displacement of the six points of mitral annulus were significantly increased（ P〈0, 01 ） ,Tds-diff and Td sd were decreased（ P〈0.05） one month after CRT. TMAD correlated with LVEF, LVESV and FAC （ r = 0.4/9, r = 0. 529, r = 0. 567, P 〈0.05） one month after CRT. Conclusions TMAD is a new technology to evaluate the short term effect of CRT.