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组织运动二尖瓣环位移技术定量评价心肌致密化不全患者左心室收缩功能 被引量:1

Quantitative evaluation of left ventricular systolic function by tissue motion annular displacement in patients with noncompaction of ventricular myocardium
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摘要 目的 应用二尖瓣环自动追踪技术(TMAD)评价心肌致密化不全患者左心室整体收缩功能,研究该方法与简化双平面Simpson法测量左心室收缩功能间的相关性及应用前景.方法 选取心肌致密化不全(NVM)患者21例为病例组,健康者23名为对照组.二维测量左心室舒张末期内径(LVEDd),应用双平面法测量左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)和左室射血分数(LVEF).使用TMAD技术测量心尖四腔观(侧壁、后间隔)、心尖两腔观(前壁、下壁)二尖瓣环4个位点的收缩期最大位移(Ds)、二尖瓣环4个位点平均位移、二尖瓣环连线中点处位移及二尖瓣环连线中点平均位移(分别记为DS侧、DS间、DS前、DS下、DS平均、DSmid1、DSmid2、DSmid平均),并分析其与LVEF的相关性.结果 与对照组相比,病例组的LVEDd、LVEDV、LVESV均显著增加(P<0.01),LVEF显著减低(P<0.01);病例组二尖瓣环4个位点Ds显著减低,差异有统计学意义(P<0.01);病例组二尖瓣环位移DS平均、DSmid平均、DSmid1l、DSmid2与LVEF呈显著正相关,以DS平均、DSmid平均与LVEF位移相关性最好(r=0.870,P<0.01;r=0.865,P<0.01),心尖四腔观切面二尖瓣环中点位移DSmd1与LVEF的相关性也很好(r=0.849,P<0.01).结论 病例组二尖瓣环4个位点DS平均、DSmid平均、心尖四腔观切面二尖瓣环中点位移DSmidl与左心室整体收缩功能均呈正相关.应用TMAD技术可以简单、准确、客观地评价NVM患者的左心室收缩功能。 Objective To evaluate the left ventricular systolic function of patients with noncompaction of ventricular myocardium (NVM) by tissue motion annular displacement (TMAD). And to observe the relevance and application prospects between TMAD and simplified biplane Simpson methods in the assessment of left ventricular systolic function in patients with NVM. Methods The ventrlcular noncompaction group and the control group were composed of 21 patients with NVM and 23 healthy subjects respectively. Left ventricular end diastolic dimension (LVEDd), left ventricular end systolic volume (LVESV), left ventricular end diastolic volume (LVEDV) and left ventricular ejection fraction (LVEF) were measured by two-dimensional echocardiography. The maximal displace- ment(Ds ), mean displacement(Ds_m), systolic displacement of the middle point(Ds_,~d), and mean displacement of the middle point of the four points of mitral annulus including lateral and posteroseptal sites from apical four- chamber views, and anterior and inferior sites from apical two-chamber views (marked as Ds-1, Ds-p, Ds-a, Ds-i, Ds-m, Ds-mid1, Ds-mid2, and DS-mid-m respectively) were measured with TMAD, and the correlation between mitral annular motion parameters and LVEF was analyzed. Results Compared with healthy subjects, the LVEDd, LVESV and LVEDV increased significantly(P〈0.01 ), and the LVEF decreased significantly(P〈0.01 ) in NVM group. The Ds of the four sites of mitral annulus were significantly lower in the NVM group than those in the health group(P〈 0.01 ). The parameters of Ds_m, Ds_,,/al, Ds_n~, and Ds-~d-m in the NVM group showed a positive correlation with LVEF, especially the parameters of Ds-m and Ds-mid-m, showed significantly statistical difference (r=0.870,P〈0.01, r=0.865,P〈0.01 ). Especially Ds-mid1 from apical four-chamber views had significant correlation with LVEF (r= 0.849,P〈0.01 ). Conclusion In patients with NVM, Ds-m, Ds-mid1, and Dsid-m of the four sites of mitral annulus correlated well with left ventricular systolic function. TMAD is a simple but accurate and objective technology to evaluate global LV systolic function in patients with NVM.
出处 《中国心血管病研究》 CAS 2014年第11期1015-1018,1053,共5页 Chinese Journal of Cardiovascular Research
关键词 超声心动图描记术 心肌致密化不全 二尖瓣 左心功能 Echocardiography Noncompaction of ventricular myocardium Mitral valve Left ventricular function
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参考文献4

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