应变和应变率成像定量评价二尖瓣成形术后左室收缩功能的改变

Quantitative assessment of left ventricular systolic function changes after mitral valve plasty by strain and strain rate imaging

目的探讨超声应变和应变率成像技术定量评价二尖瓣成形术后左心室收缩功能变化的价值。方法拟行二尖瓣成形术的心功能不全患者,术前行超声心动图检查,记录左室舒张末期内径(LVDd)和左室射血分数(LVEF);并在心尖四腔心和心尖两腔心切面,应用应变和应变率技术测量室间隔、侧壁、前壁及下壁的基底段和中段收缩期峰值应变(Ss)和收缩期峰值应变率(SRs)。术后7d和3个月随访观察LVDd、LVEF、Ss和SRs的变化。并与对照组30例正常人进行对比分析。结果二尖瓣成形术组术前Ss和SRs值较对照组明显减低(p<0.05);与术前比较,术后7d部分节段Ss和SRs值增高(P<0.05);术后3个月所有节段Ss和SRs值均有明显增高(P<0.01),LVDd值减小(P<0.05),LVEF增加(P<0.05)。结论应用应变和应变率成像技术能够早期准确评价二尖瓣成形术后左室功能的改变。

Objective To explore the value of strain and strain rate imaging in assessment of left ventricular systolic function changes after mitral valve plasty （MVP）. Methods The patients arranged for MVP with cardiac dysfunction were enrolled in the study. Then they were examined by echocardiography before operation, the left ventricular diameter of the end diastole （LVDd） and ejection fraction（LVEF） were recorded, systolic strain （Ss） and strain rate （SRs） from intelwentricular septum, lateral wall, anterior wall and inferior wall at apical 4-chamber and 2-chamber view were detected by strain and strain rate imaging. The changes of LVDd, LVEF, Ss and SRs were followed up at 7 days and 3 months after operation. The results were compared with those of 30 healthy subjects. Results Compared with control group, Ss and SRs in MVP group were decreased （P 〈 0.05 ） ; compared with those before MVP, Ss and SRs in part of the cardic segments were higher after 7 days （P 〈 0.05 ）, and Ss and SRs in all the segments were increased at 3 months after MVP （ P 〈 0.01 ）, LVDd was decreased and LVEF was increased （P 〈 0.05）. Conclusion Strain and strain rate imaging can accurately and early evaluate the changes of left ventrieular systolic function after MVP