超声三维斑点追踪成像技术评价慢性心力衰竭患者左心室整体应变的初步研究

Primary study of three-dimensional assessment of left ventricular globe strain in patients with chronic heart failure by ultrasonic speckle tracking technology

目的应用三维斑点追踪成像技术初步评价慢性心力衰竭(CHF)患者左心室整体径向、纵向、环向收缩期峰值应变特征,并探讨其价值及可行性。方法 CHF患者29例(CHF组)及正常志愿者34例(正常组),采集标准心尖四腔切面左心室全容积图像并存储,应用3-Dtrace软件进行在线分析,自动计算左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)、左心室整体纵向收缩期峰值应变(LVGLS)、左心室整体环向收缩期峰值应变(LVGCS)及左心室整体径向收缩期峰值(LVGRS),并比较CHF组与正常组之间的各应变指标变化情况及与LVEF的相关性。结果 CHF患者左心室LVEF、LVGLS、LVGCS、LVGRS较正常组减低(P<0.05)。LVGLS、LVGCS、LVGRS与LVEF相关系数分别为0.846、0.871和0.828(P<0.01)。结论 CHF患者左心室整体功能明显减低,三维斑点追踪技术可无创、客观地评价左心室整体收缩功能,为评价左心室功能提供一个新的手段。

Objective To assess left ventricle（LV） global function in patients with chronic congestive heart failure by three-dimensional ultrasound speckle tracking imaging. Methods Twenty-nine of patients with chronic congestive heart failure（CHF） and thirty-four healthy volunteers were included. The real-time 3D datasets （Toshiba Artida 4D System）were recorded from left ventricular apical four-chamber views to measure values of left ventricular end-systolic and end-diastolic volumes （LVESV and LVEDV） ,left ventricular ejection fraction （ LVEF）, and global longitudinal peak systolic strain （ LVGLS）, global circular peak systolic strain（LVGCS） and global radial peak systolic strain（LVGRS）. The values were compared between the two groups. The correlations between LVEF, LVGLS, LVGCS and LVGRS were analyzed respectively. Results The left ventricular of LVEF, LVGLS, LVGCS, LVGRS were significantly impaired in patients with chronic congestive heart failure compared with controls（P 〈 0.05 for all）. The correlations among LVEF and LVGLS,LVGCS, LVGRS were found （r = 0. 846, 0. 871, 0. 828, respectively, P 〈 0. 01 for all）. Conclusions The left ventricular global function decreased in patients with CHF. The left ventricular global function can be non-invisibly and objectively studied by three-dimensional ultrasonic speckle tracking imaging, which could be new means for the evaluation of left ventricular function.