斑点追踪成像评价心肌梗死患者左心室纵向应变与径向应变的关系

Evaluation of relationship between longitudinal and radial strains of left ventricular in patients with myocardial infarction by speckle tracking imaging

目的应用斑点追踪成像（STI）技术评价心肌梗死患者左室心肌收缩期长轴纵向峰值应变（LSPS）与短轴径向峰值应变（RSPS）的关系。方法对60例健康人和90例心肌梗死患者进行斑点追踪应变成像分析，在心尖两腔、三腔和四腔观获得左室各节段LSPS，在左室短轴二尖瓣、乳头肌、心尖部水平成像获得左室各节段RSPS；比较正常组与心肌梗死组LSPS与RSPS之间的差异；比较LSPS与RSPS诊断心肌梗死的准确性。结果心肌梗死组患者梗死节段LSPS及RSPS明显低于正常组，差异有统计学意义（P〈0．01）。LSPS与RSPS均能有效地检出左室的梗死节段，两者检测的准确性分别为91．2％及89．5％，差异无统计学意义（P〉0．05）。结论STI技术的LSPS及RSPS定量测定左室局部收缩功能具有较高的准确性与可重复性；两项指标对Q波梗死节段的检测能力准确等效。

Objective To assess longitudinal strain（LS） and radial strain（RS） of left ventricular and their relationship in patients with myocardial infaretion（MI） by speckle tracking imaging（STI）. Methods Two dimensional echocardiography（2DE） was performed to measure peak systolic LS and RS in 60 healthy subjects and 90 patients with MI by STI. 2DE images with high frame rate were recorded from the left ventricular short axis views at the levels of mitral annulus, papillary muscle and apex, and from the apical two-,three- and four-chamber views. And LS was measured in the apical long-axis views and RS in the left ventricular short-axis views respectively by two-dimensional strain software. Results There were notably differences between normal and infarcted segments for peak systolic LS （ P 〈0.01） and RS （ P 〈0.01）, respectively. The accuracy for the indentification of the infarcted segments was similar either by LS or RS （P 〉 0.05）. Conclusions STI is able to quantitatively assess myocardial systolic function, and peak systolic LS and RS are equal in the indentification of the infarcted segments.