全方向M型超声评价扩张型心肌病患者左心室收缩同步性

Assessment of left ventricular systolic synchronicity with omnidirectional M-mode echocardiography in dilated cardiomyopathy patients

目的探讨应用全方向M型超声心动图评价扩张型心肌病(DCM)患者左心室心肌径向收缩运动同步性的临床价值。方法对21例DCM心衰患者与27例健康志愿者,应用全方向M型超声检测左心室短轴基底段及中间段水平各节段室壁达收缩期最大位移时间,计算各短轴水平经心率校正的室壁达收缩期最大位移时间(Tc)的最大差值(Tc-dif)及标准差(Tc-SD)、间隔-左心室后壁延迟时间(SPWMD)、间隔-左心室前壁延迟时间(SAWMD)、间隔-左心室侧壁延迟时间(SLWMD)、间隔-左心室下壁延迟时间(SIWMD)、前壁-下壁延迟时间(AIWMD)。结果在二尖瓣水平,DCM组的Tc-dif、Tc-SD、SLWMD、SPWMD、SIWMD均大于对照组(P<0.05),在乳头肌水平DCM组的Tc-dif、Tc-SD、SAWMD、SP-WMD、SIWMD、AIWMD均大于对照组(P<0.05)。结论全方向M型超声能够评价扩张型心肌病患者左心室心肌径向收缩的同步性。

Objective To assess left ventricular radial systolic synchronicity with omnidirectional M-mode echocardiography （OME）. Methods OME examination was performed in 21 patients with dilated cardiomyopathy （DCM） and 27 healthy controls. The time to peak radial systolic movement were measured and adjusted by R-R interval. The standard deviation （Tc-SD）and the maximal temporal difference （Tc-dif） of the time to peak radial systolic movement of left ventricular short-axis segments at basal and mid-levels, the septal-to-posterior wall motion delay （SPWMD）, septal-to-anterior wall motion delay （SAWMD）, septal-to-laterior wall motion delay （SLWMD）, septal-to-inferior wall motion delay （SIWMD） and anterior-to-inferior wall motion delay （AIWMD） were used as indicators of systolic dyssynchrony. Results Compared with the controls, Tc-dif, Tc-SD, SLWMD, SPWMD and SIWMD in basal level were significantly higher in the DCM group （P （0.05）, while Tc-dif, Tc-SD, SAWMD, SPWMD, SIWMD and AIWMD in mid-level were significantly higher in the DCM group （P〈0.05）. Conclusion Omnidirectional M-mode echocardiography is useful to evaluate the radial systolic synchrony of the left ventricular in patients with dilated cardiomyopathy.