二维斑点追踪成像评价急性心肌梗死患者左室扭转及解旋的研究

Left Ventricular Twist in Patients with Acute Myocardial Infraction Evaluated by Two-dimensional Speckle Tracking Echocardiography

目的采用超声二维斑点追踪成像(STI)评价急性心肌梗死(AMI)患者左室扭转及解旋变化。方法 45例AMI患者(AMI组)及48例正常人(NOR组),采用STI测量左室基底及心尖段心肌旋转及解旋角度峰值(Ptw base,Ptw apex,UntwR base,Untw Rapex)、左室扭转角度峰值(Ptw)、左室解旋率峰值(UntwR)、左室扭转达峰时间(TPtw)和左室解旋达峰时间(TPUR)。结果 AMI组Ptw base、Ptwapex、Ptw、UntwR base、UntwR apex和UntwR减低(P<0.01)。AMI组TPtw早于NOR组(P<0.01)。LVEF与Ptw apex、Ptw相关性良好(P<0.001)。结论 STI可通过检测心肌扭转评价AMI患者左室收缩及舒张功能,为临床提供一种可靠的新方法 ,具有广泛的应用前景。

Objective To evaluate the left ventricular twist and untwist in patients with acute myocardial infarction（AMI） using twodimensional speckle tracking echocardiography（STE）.Methods A total of 45 AMI patients and 48 healthy control subjects were included in this study.Two-dimensional strain was performed.The peak apical rotation（Ptw apex）,peak basal rotation（Ptw base）,peak left ventricular twist（Ptw）,peak basal untwisting rate（UntwR base）,peak apical untwisting rate（UntwR apex）,peak LV untwisting rate（Untw R）,and time to peak left ventricular twist and untwist rate（TPtw,TPUR）were measured.Results Compared with control subjects,peak left ventricular rotation parameters significantly decreased in AMI patients（P〈0.01）.A strong correlation was found between peak left ventricular twist and left ventricular ejection fraction（P〈0.001）.Conclusion STI could be used to evaluate the left ventricular systolic and diastolic function by measuring the left ventricular twist and untwist.