组织运动二尖瓣环位移自动追踪技术定量评价心功能减低患者左心收缩功能及病变程度

Tissue motion mitral annular displacement in evaluation on mitral annular displacement for left ventricular systolic function and degree of reduced cardiac function

目的观察应用组织运动二尖瓣环位移自动追踪(TMAD)技术定量评估心功能减低患者左心收缩功能的意义。方法根据双平面Simpson法测定的左心室射血分数(LVEF),收集125例心功能减低患者为心功能减低(LVEF≤54%)组,50名健康体检心功能正常(LVEF≥55%)者为正常对照组。将心功能减低组再分为LVEF 50%～54%、LVEF45%～49%、LVEF 40%～44%、LVEF 35%～39%及LVEF≤34%亚组,各25例。在室间隔和侧壁上描记两点,分别记为第1点和第2点,软件自动计算二者的最大位移;将两点连线,中点记为第3点,计算最大位移及其占左心室长径百分比。结果心功能减低组TMAD各项参数均显著低于正常对照组(P均<0.01)。TMAD各参数均与LVEF呈正相关(P均<0.01)。结论 TMAD参数有望成为评价左心室收缩功能的一个新的、甚至可替代LVEF的指标。

Objective To assess the effect of tissue motion mitral annular displacement（TMAD） in evaluation on left ventricular systolic function（LVSF） in patients with the reduced cardiac function.Methods According to the left ventricular ejection fraction（LVEF） attained using Simpson double-plane method,125 patients with reduced cardiac function（LVEF≤54%） were enrolled as reduced cardiac function group,and were divided into 5 subgroups according to LVEF,i.e.LVEF 50%—54%,LVEF 45%—49%,LVEF 40%—44%,LVEF 35%—39% and LVEF≤34% subgroups（each n=25）.Fifty healthy subjects（LVEF≥55%） served as control group.The subjects in each group were measured by TMAD.Two points at septum and the lateral wall were recorded as the first and the second point,respectively.After connecting two points,the midpoint was recorded as the third point.The maximum displacement of the first,the second and the third point were calculated,as well as the ratio of the maximum displacement of the third point accounted for length diameter in ventriculus sinister.Results The parameters of TMAD in all reduced cardiac function subgroups were significantly lower than those of control group（all P0.01）.There was positive correlation between the parameters of TMAD and LVEF（all P0.01）.Conclusion The parameters of TMAD can be regarded as new indicators which might even substitute for LVEF in evaluation on left ventricular systolic function.