超声心动图结合二维应变评价左室再同步化治疗慢性心力衰竭患者的短期疗效

Assessment of the Short-Term Efficacy of Cardiac Resynchronization Therapy via Two-Dimensional Strain Echocardiography in Patients with Chronic Heart Failure

目的:应用二维应变超声心动图评价慢性心力衰竭(chronic heart failure,CHF)患者在安装三腔起搏器进行左室再同步化治疗(cardiac resynchronization therapy,CRT)后的短期疗效。方法:选择行植入CRT的患者31例,分别在CRT术前、术后2周及术后3个月测量左室射血分数(left ventricular ejection fraction,LVEF)、左室舒张末内径(left ventricular end-dia-stolic diameter,LVEDD)、左室收缩末内径(left ventricular end-systolic diameter,LVESD),应用二维应变成像技术分析左室壁16个节段的径向应变(radial strain,RS)峰值、环向应变(circumferential strain,CS)峰值及纵向收缩期(longitudinal systolic strain,LS)峰值。结果:与术前相比,术后2周及术后3个月的LVEDD、LVESD和LVEF及左室壁16个节段的RS峰值、CS峰值和LS峰值均有不同程度改善。术后2周与术后3个月相比,LVEDD、LVESD、LVEF及左室壁16个节段的LS峰值差异均有统计学意义,而RS峰值与CS峰值差异均无统计学意义。术后2周及术后3个月心脏同步性均较术前有显著改善。结论:二维超声技术能定量检测CRT后心脏结构变化的数据。CRT术后可逆转心室重构,改善CHF患者的心功能。

Objective： To assess the short-term efficacy of cardiac resynehronization therapy （CRT） using two-dimensional strain echocardiography in patients with chronic heart failure （CHF）. Methods： A total of 3l CHF patients treated with CRT were enrolled in this study. Left ventricular end-diastolic diameter （LVEDD）, left ventricular end-systolic diameter （LVESD） and left ventricular ejection fraction（LVEF）were measured two weeks before and three months after CRT. Radial strain （RS） peak, circumferential strain （CS） peak and longitudinal systolic strain （LS） peak of 16 left ventrieular segments were measured using two-dimensional echocardiography. Results： LVEF, LVEDD, LVESD, RS peak, CS peak, LS peak were improved after CRT. CRT increased LVEF, decreased LVEDD and LVESD. CRT also shortened LS peak after three months （P〈0.05）. Cardiac resynchronization was achieved after CRT. Conclusions： CRT can significantly improve the cardiac function in patients with CHF. Two-dimensional strain echocardiography can provide unique quantitative information for assessing the short-term outcome of CRT.