心力衰竭患儿左室非同步运动与二尖瓣环运动速度的定量组织速度成像研究

Study of quantitative tissue velocity imaging on left ventricular asynchrony and mitral annulus velocities in children with congestive heart failure

目的探讨心力衰竭患儿左室非同步运动与二尖瓣环运动速度之间的关系。方法健康小儿40例，心力衰竭患儿30例，获取标准心尖四腔和两腔观。①在多普勒组织速度成像（DTI）状态下，测量左室后间隔、侧壁、前壁、下壁收缩期和舒张早期频谱中的峰值速度（Vs、Ve），计算四个壁Vs和Ve均值；②QTVI状态下，测量并计算左心室四个壁12节段同步性指标Ts、Te的最大差值Max－△Ts和Max－△Te。同时测量左心功能指标左室射血分数（LVEF）。结果心力衰竭组Max—△Ts和Max—△Te明显大于正常对照组，差异有统计学意义（P〈0．01）；Vs、Ve的均值明显低于正常对照组，P〈0．01；直线相关分析显示MeanVs与Max—△Ts、MeanVe与Max－△Te、Max—△Ts与LVEF相关性好。结论心力衰竭患儿左室内心肌存在非同步运动现象，与二尖瓣环运动速度相关性好，可导致心功能下降。

Objective To explore the relationship between left ventricular asynchrony and mitral annulus velocities in children with congestive heart failure （CHF） by quantitative tissue velocity imaging（QTVI）. Methods The standard cardiac apical four chamber and two chamber view of 40 normal children and 30 children with CHF were obtained by QTVI. ①DTI： the peak value of LV posteroseptal, lateral, anterior and inferior walls and early diastolic spectra were measured, and MeanVs, MeanVe of four walls were calculated . ② QTVI： The maximal difference in Ts and Te within all 12 segments （Max-△Ts and Max-△Te） of LV were calculated, and the left ventrienlar ejection fraction （LVEF） was measured at the same time. Results Max-△Ts and Max-△Te in CHF group were obviously more than those in control group, there was significant difference in the two groups （P 〈 0.01 ）. MeanVs and MeanVe were obviously lower than those in control group （P 〈 0.01 ）. Linear correlation analysis showed MeanVs, MeanVe, Max-△Ts had respectively good relation with Max-△Ts , Max-△Te and LVEF. Conclusion The intraventricular asynchrony exists in children with CHF and it has good relation with mitral annulus velocities, it is also harmful to LV function.