二维应变超声对原发性扩张型心肌病及缺血性心肌病左房心肌功能评价的研究

Left atrial myocardial function in patients with either idiopathic or ischemic dilated cardiomyopathy evaluated with two-dimensional strain echocardiography study

目的应用二维应变超声测量法(2DSE)评估原发性扩张型心肌病患者及缺血性心肌病患者收缩功能的差异。方法对30例扩张型心肌病患者(50±14.6)岁及44例缺血性心肌病患者(52±16.9)岁的左房间隔部、游离壁及顶部的纵向应变进行标准多普勒超声及2DSE测量分析。结果两组患者左室容积,射血分数,二尖瓣返流面积及二尖瓣返流量差异没有统计学意义。但是,扩张型心肌病患者左房主动排空量及排空分数较缺血性心肌病患者明显减少。扩张型心肌病左房各测量部位的收缩期纵向应变峰值也低于缺血性心肌病患者。结论二维应变超声测量对于扩张型心肌病患者左房功能异常有较好的评价作用。原发性扩张型心肌病患者与缺血性心肌病相比,左房收缩期功能降低。

Aim To detect LA systolic dysfunction by two-dimensional strain Echocardiography （2DSE） in patients with either idiopathic or ischemicDCM. Methods 74 patients with either idiopathic （70 patients） or isebemic （44 patients） DCM underwent standard Doppler echo and 2DSE analysis of atrial longitudinal strain in the basal segments of LA septum and LA lateral wall, and in LA roof. Results The clinical variables. LV volumes, ejection fraction, stroke volume, and mitral valve effective regurgitant orifice of the two groups were similar. LA active empting volume and fraction in isehemie patients were lower than that of idiopathic patients （P〈0. 01）. Peak systolic myocardial atrial strain was significantly reduced in patients with idiopathic DCM compared with ischemic DCM （P〈0. 001）. Conclusions Two-dimensional strain represents a promising non-invasive technique to assess LA atrial myocardial function in patients with DCM. LA systolic deformation is more depressed in idiopathic compared with ischemic DCM.