实时三平面组织追踪成像定量评价心肌梗死患者左心室长轴位移

Quantitative evaluation of left ventricular long axis systolic displacement in myocardial infarction patients with real-time triplane tissue tracking imaging

目的:应用实时三平面组织追踪成像(Triplane-TTI)技术定量评价心肌梗死(MI)患者二尖瓣瓣环及左心室各节段心肌收缩期位移特点。方法:单纯左前降支MI患者17例(B组),左旋支或(和)右冠支MI患者19例(C组),包含左前降支病变的双支或多支患者23例(D组),健康志愿者25例作为对照组(A组)。采集Triplane-TTI图像,分析获得各室壁房室平面收缩期最大位移(AVPD)及各节段心肌收缩期最大位移(Dmax)。结果:B、C、D3组平均AVPD与A组比较均减低,D组尤为显著(P<0.05)。B组下侧壁、下壁及后间隔位点,C组前间隔及前壁位点AVPD虽然减低,但与A组比较差异不具有统计学意义。A组同一水平各节段心肌Dmax差异不明显,同一室壁从基底段、中间段至心尖段Dmax逐渐减低,呈梯度变化。B、C、D 3组Dmax不同程度减低,与A组比较及3组间比较大部分心肌节段差异均具有统计学意义(P<0.05)。AVPD和Dmax减低室壁与梗死相关冠状动脉供血区域基本符合。结论:对于心肌梗死患者应多位点测量AVPD,避免高估或低估;Dmax能准确反映MI患者左心室局部心肌收缩功能的变化。

AIM：To evaluate the left ventricular long axis systolic displacement in myocardial infarction patients with real-time triplane tissue tracking imaging. METHODS： Fifty-nine patients with myocardial infarction were divided by coronary artery angiography into three groups： group B of 17 patients with single left anterior descending （LAD） coronary artery stenosis, group C of 19 patients with left circumflex coronary artery or/and right coronary artery stenosis and group D of 23 patients with double or triple coronary arteries stenosis with LAD. Twenty-five healthy subjects were selected as group A of normal control group. Systolic atrial ventricular plane displacement （AVPD） and the systolic maximum displacement （Dmax） of left ventricular segmental movement were measured by triplane-TTI. RESULTS： The average AVPD in group B, group C and group D （especially that of group D） decreased significantly compared with that in group A （P〈0.05）. The AVPD of posterior, inferior and posteroseptal sites in group B and of anteroseptal and anterior sites in group C were not significantly different from those in group A. In group A, the Dmax was the basal segment 〉 the middle segment〉the apical segment, with no significant difference in the same level segment. In group B, group C and group D, the Dmax significantly decreased in segments compared with that in group A （all P〈0.05）. The decrease of AVPD and Dmax was in compliance with the area where infarction coronary blood supplies. CONCLUSION： Evaluation of AVPD in many sites could prevent over- or undervaluation and Dmax could objectively and accurately reflect left ventricular regional systolic functions in patients with myocardial infarction.