二维超声斑点追踪技术评价先天性主动脉瓣重度狭窄卡瓦术后早期左室局部收缩功能

The evaluation of the changes of early-stage left ventricular systolic function after comprehensive aortic root &valve reconstruction surgery using 2D-STI for patients with severe aortic valve stenosis

目的应用二维超声斑点追踪(2D-STI)技术评价左室射血分数(LVEF)正常的先天性重度主动脉瓣狭窄(AS)患者卡瓦(CARVAR)术后早期左室局部收缩功能的变化。方法 35例先天性重度AS且LVEF正常拟行卡瓦手术的患者,分别于术前1周、术后1个月、6个月通过2D-STI对左室壁各节段收缩期纵向应变及应变率进行定量分析。结果卡瓦术后1个月患者LVEF由(63.46±4.7)%下降为(55.68±4.5)%,但差异无统计学意义(P>0.05);左室壁各节段纵向应变及应变率术后1个月低于术前及术后6个月,术后6个月高于术前,即术后6个月>术前>术后1个月,差异均有统计学意义(P<0.05)。结论 2D-STI技术能够早期、客观、准确地评价重度AS患者卡瓦术后左室局部心肌收缩功能改变,具有重要的临床应用价值。

Objective To evaluate the changes of early-stage left ventricular systolic function after comprehensive aortic rootvalve reconstruction（ CARVAR） surgery by using two-dimensional speckle tracking imaging（ 2 D-STI） for patients with severe aortic valve stenosis（ AS） with normal left ventricular ejection fraction（ LVEF）. Methods 35 patients with severe AS and LVEF normal operation were 20 - 66 years old,with an average of（ 45 ± 4. 3） years of age. The longitudinal strain（ LS） and strain rate（ LSr） of each segment of the left ventricular wall were quantitatively analyzed by 2 D-STI in one week before the operation and in one month and six months after the operation respectively. Results The LVEF value of the patients after CARVAR surgery decreased from（ 63. 46 ±4. 7） % to（ 55. 68 ± 4. 5） %,but the difference was not statistically significant（ P〉0. 05）. The longitudinal strain and strain rate of each segment of the left ventricular wall was lower in one month after the operation than one week before the operation and six months after the operation. which meant that the longitudinal strain and strain rate in six months after operation was higher than one months after operation,and the difference was statistically significant（ P〈0. 05）. Conclusions 2 D-STI technique could objectively and accurately evaluate the changes of early-stage left ventricular systoly function in severe AS patients; and it has the important clinical value.