组织同步成像评价糖尿病心肌病左心室收缩同步性的研究

Evaluation of systolic synchronism of ventricular motion in patients with diabetic cardiomyopathy by tissue synchronization imaging

目的探讨组织同步成像(TSI)对糖尿病心肌病(DCM)患者左心室收缩同步性的诊断价值。方法选择糖尿病心肌病患者30例和正常对照者30例进行超声心动图检查。使用GE Vivid 7在TSI模式下测量12个心肌节段收缩期达峰值速度时间(time to peak systolic velocity,Ts)、计算12个心肌节段Ts的标准差(Ts-SD),仪器自动计算TSI指数,并以彩色牛眼图显示出来。结果 DCM组除中间段(Masept)外,其他11个节段心肌Ts均较正常对照组明显延长,差异具有统计学意义(P=0.024和P≤0.001);DCM组Ts-SD较正常对照组延长,差异具有统计学意义(P<0.001)。TSI指数除sept post-delay外,其余指标DCM组与正常对照组差异具有统计学意义(P<0.001)。心肌收缩延迟程度与年龄及左房大小均呈正相关(P≤0.001),与性别无相关性。结论 DCM患者早期即出现心肌收缩不同步,以轻度延迟为主,晚期患者的中重度延迟较早期患者增多,TSI技术可对其进行准确评价。

Objective To evaluate the dyssynchrony contraction of left Ventricular （LV） with diabetic cardiomyopathy by tissue synchronization imaging （TSI） technique. Methods Consecutive thirty patients with diabetic cardiomyopathy were DCM group. Thirty healthy subjects without any cardiac diseases were controls. TSI images of LV were obtained simultaneously using GE Vivid 7 ultrasound imaging system and the time to peak systolic velocity （Ts） of twelve segments were measured. The standard deviation of Ts of the 12 LV segments （Ts-SD） were analyzed. The index of TSI was calculated automatically by the machines and the results would be displayed by the colorful ＂ox^s eye＂ image. Results The Ts of all the other 11 segments in DCM group was significantly longer than that of the control group except Masept （ P = 0. 024 and P ≤0. 001）. The Ts-SD in DCM group were significantly longer than that of the control group （ P 〈0. 001）. The index of TSI in DCM Group and the control group was remarkable different except sept post-delay （ P 〈0. 001）. In DCM Group, the latency of myocardial contraction was positively related with age and the size of left ventricle （ P ≤0. 001）, and it was unrelated with sex. Conclusion The dissynchrony contraction of LV with DCM may occur in the early stage of DCM, however its dissynchrony contraction was mildly langer. For the moderate and severe stage casees of DCM, its dissynchrony contraction was much longer than that of early stage of DCM. TSI can offer the accurate and quick quantitative detection of the dissynchrony contraction of LV.