应变率成像定量评价孤立性房颤患者局部左房功能的研究

Study of Quantitative Estimate Regional Left Atrium by Strain Rate Imaging in Lone Atrial Fibrillation

目的:探讨应变率成像技术定量评估孤立性房颤患者左房局部功能的临床应用价值。材料与方法:随机选取来我院就诊的孤立性房颤患者50例,行常规超声心动图检查,在超声组织速度成像状态下获取心尖四腔、两腔、左室长轴切面动态图像,将左房间隔壁、侧壁、前壁、下壁、前间隔和后壁分别按照基底段、中间段和心尖段划分为18个节段。观察左房各壁的基底段和中间段,测量收缩期峰值应变率(SR-LAs)和舒张期应变率(SR-LAe和SR-LAa),并与40例健康人相应节段心肌比较。结果:正常对照组40例480个被研究心肌节段,470个节段的应变率-时间曲线的形态整体有一定的规律性,SR-LAs、SR-LAe和SR-LAa值随个体变化不大。孤立性房颤患者组被研究600个心肌节段,应变率-时间曲线显示523个节段失去正常形态,轮廓杂乱,波峰低小、消失甚至倒置,峰值较正常心肌节段明显降低(P<0.05)。结论:用应变率成像技术能够无创的定量评价孤立性房颤所致的左房功能异常。

Purpose：This study was done to quantitative estimate the left atrial regional function using strain rate imaging in patients with lone atrial fibrillation. Materials and Methods：Forty normal subjects and fifty patients with lone atrial fibrillation were studies by conventional echocardiography.The dynamic tissue velocity imaging were obtained at apical four-chamber view and two-chamber view and apical longitudinal view.Septal,lateral,anterior,inferior,anteroseptal and posterior walls were divided into basal,mid and apical segments respectively.The systolic strain rate（SR-LAs） and the diastolic strain rate（SR-LAe and SR-LAa） were measured respectively at basal and middle segments of each wall and compared with that of the controls.Results：The shapes of strain rate-time curve of 470/480 normal myocardial segments were regularity and the peak value of strain rate did not vary with individual.600 segments were investigated in patients with lone atrial fibrillation,and we found the shapes of strain rate-time curve of 523 segments were deformed and the peak value of strain rate was lower than that of controls（P0.05）. Conclusion：Based on our findings,we conclude that noninvasive quantification of LA function using SR imaging enables evaluation of LA dysfunction in lone atrial fibrillation.