斑点追踪技术评价主动脉瓣狭窄瓣膜置换术前后左心室扭转功能

Left ventricular reverse function assessed by speckle tracking technique in patients with aortic stenosis before and after valve replacement

目的:分析并探讨斑点追踪技术评价主动脉瓣狭窄瓣膜置换术前后左心室扭转功能变化。方法:选择我院接受治疗的主动脉瓣狭窄瓣膜置换术患者31例为主动脉瓣狭窄组,选择同期体检健康者31例为健康对照组。使用斑点追踪技术评价置换术前后各项参数变化情况,并进行对比。结果:与健康对照组比较,主动脉瓣狭窄组术前室间隔厚度[(9.89±1.13)mm比(14.88±2.41)mm]及左室后壁厚度[(8.76±1.29)mm比(12.81±1.97)mm]明显增厚,主动脉瓣口面积[(2.84±0.55)cm^2比(0.79±0.24)cm^2]明显减小,二尖瓣环舒张早期运动速度(Em)[(8.81±2.25)cm/s比(7.16±2.33)cm/s]明显降低(P<0.05或<0.01);与术前相比,主动脉瓣狭窄组术后主动瓣口面积[(1.55±0.42)cm^2]明显增加,Em值[(9.37±2.22)cm/s]明显升高(P<0.05或<0.01)。与健康对照组比较,主动脉瓣狭窄组心尖扭转角度[(7.7±2.7)°比(13.2±4.7)°],左心室扭转角度[(13.0±3.3)°比(19.9±5.8)°]显著增大;与术前比较,主动脉瓣狭窄组术后心尖扭转角度[(13.2±4.7)°比(8.8±4.6)°]与左心室扭转角度[(19.9±5.8)°比(14.1±5.4)°]明显减小至正常水平(P<0.05或<0.01)。结论:主动脉瓣狭窄患者左心室心尖扭转角度明显增大,从而造成左室扭转角度增大,瓣膜置换术后可恢复至正常。

Objective： To explore left ventricular reverse function change assessed by speckle tracwith aortic stenosis （AS） before and after valve replacement （VR）. Methods： A total of 31 AS patients undergoing VR in our hospital were enrolled as AS group, another 31 healthy subjects undergoing physical examination during the same period were enrolled as healthy control group. All index changes were assessed by speckle tracing techniquand they were compared with those of healthy control group. Results： Compared with healthy control grousignificant rise in interventricular septal thickness （VST） [ （9. 89 ± 1 13） mm vs. （14. 88 ± 2. 41） mm] lar posterior wall thickness （LVPWT） [ （8. 76 ± 1 29） mm vs. （12. 81 ± 1 .97） mm] , significant area [ （2. 84 ± 0. 55） cm^2 vs. （0. 79 ± 0. 24） cm^2] and early diastolicmitralannular velocity （Em） [ （8. 81 ± 2. 25） cm/s vs. （7.16 ± 2.33） cm/s] in AS group,P〈0.05 or 〈 0 .01; compared with before operation, there were significant rise inaorticvalvearea[（1.55±0.42）cm^2] and Em[ （ 9.37±2.22 ）cm /s ] in AS group,P 〈 0 .05 or〈 0.01 .Comparedw 1 thhealthy control group,there were significant increase in cardiac apex reverse angle [ （7.7 ± 2.7）vs. （13.2 ± 4.7 ） ] , leftventricular reverse angle [ （13. 0 ± 3. 3）vs. （19.9 ± 5.8）. ] ; Compared with before operation,there were significant reductions to normal levels in postoperative cardiac apex reverse angle [ （13. 2 ± 4. 7）vs. （8. 8 ± 4. 6 ） ] and left ventricular reverse angle [ （19.9 ± 5. 8）vs. （14.1 ± 5. 4 ） ] inAS group,P 〈 0 . 05 or 〈 0 . 01. Conclusion： Left ventricular cardiac apex reverse angle significantly rises in AS patients,which leads to increased left ventricular reverse angle. It can recover to normal after valve replacement.