二维应变超声评价室壁运动正常的冠状动脉性心脏病患者的左心室扭转运动

Two-dimensional strain echocardiography in evaluation of left ventricular twist with normal ventricular wall motion

目的应用二维应变超声心动图(2DSE)定量分析常规方法显示室壁运动正常的冠状动脉性心脏病(CHD)患者的左心室扭转运动,探讨其临床应用价值。方法采集经冠状动脉造影证实的38例CHD患者和31例对照组患者的左心室短轴二尖瓣环及心尖水平切面的二维灰阶动态图像,测量各项左心室扭转指标并获得相应曲线;二维双平面Simpson法测量左心室射血分数。结果各项常规超声指标的组间差异均无统计学意义;心尖及瓣环扭转曲线的正负方向改变,组间差异有统计学意义(P<0.01);整体扭转率的组间差异亦有统计学意义(P<0.05)。结论左心室的扭转方向及整体扭转率可以检出CHD左心室壁收缩异常,敏感性高于常规超声心动图检查。

Objective To evaluate the left ventricular twist in patients with coronary heart disease （CHD） with two-dimensional strain echocardiography （2DSE）. Methods Thirty-eight patients with CHD and 31 control subjects proved with selected coronary angiography were enrolled. Two-dimensional images from LV short axis views at the levels of mitral annulus and apex in 3 continuous cardiac cycles were recorded. LV ejection fraction （LVEF） was calculated with hi-plane Simpson＇s method, torsion and torsional rate were obtained in each plane, and the corresponding curve was accessed. Results No statistical difference of conventional echocardiographie parameters such as LV diameter, left atria diameter, LVEF, FS, E/A and E-wave deceleration time were detected, while significant difference of torsional direction （P〈0. 01） and global torsion rate （P〈0.05） were found between the two groups. Conclusion The global torsional rate and torsional direction have higher sensitivity than conventional echocardiography in the diagnosis of CHD.