速度向量成像评价心尖肥厚性心肌病左室扭转角度和解旋的初步研究

Evaluation of left ventricular twist and untwist in patients with apical hypertrophic cardiomyopathy using velocity vector imaging

目的 应用速度向量成像（VVI）技术评价心尖肥厚性心肌病（ApHCM）患者左室短轴心肌扭转角度与解旋运动.方法 应用VVI技术对23例ApHCM患者和23例正常人左室短轴心底和心尖水平的心内膜下心肌扭转角度和解旋进行定量分析.结果 与正常组比较,ApHCM组左室短轴心尖部心内膜下心肌收缩期峰值旋转角度、旋转速度以及左室扭转角度均减低（P＜0.05）;而两组间心底部心内膜下心肌收缩期峰值旋转角度、旋转速度差异无统计学意义（P＞0.05）.ApHCM组舒张早期左室心底部与心尖部心内膜下心肌的峰值解旋速度均低于正常组（P＜0.05）.结论 VVI技术可有效评价ApHCM患者左室扭转角度与解旋运动特征,ApHCM患者左室心内膜下心肌的扭转角度与解旋运动均减低.

Objective To evaluate left ventricular（LV） twist and untwist using velocity vector imaging（VVI） in patients with apical hypertrophic cardiomyopathy （ApHCM）. Methods Twenty-three patients diagnosed with ApHCM were consecutively enrolled and compared with normal controls. After a standard echocardiographic examination, parasternal basal and apical short-axis planes were scanned to quantify LV rotations,twist and LV untwist using VVI. Results Compared with the normal controls, the rotation and rotaional velocity of apical subendocardial myocardium were markedly decreased in ApHCM patients during the period of systole （ P〈0.05） ,but the decreases in basal planes were not significant. As a consequence,LV twist was significantly lower in ApHCM patients （P〈 0.05）. Compared to normal controls,the velocity of LV untwisting was also significantly decreased in ApHCM patients （ P〈0.05）.Conclusions The twist and untwist of LV subendocardial myocardium were decreased in ApHCM patients.VVI is a useful method to assess the characteristics of LV twist and untwist in ApHCM patients.