斑点追踪成像联合速度向量成像技术评估慢性心衰患者左室收缩功能

Clinically applying velocity vector and speckle tracking imaging to evaluation of left ventricular systolic function in patients with chronic heart failure

目的:探讨斑点追踪成像(STI)联合速度向量(VVI)技术评估慢性心衰患者左心室收缩功能的临床价值。方法:常规超声心动图技术获取50例NYHA心功能分级法诊断心力衰竭Ⅲ～Ⅳ级且经Simpson双平面法测得EF≥50%的患者及40例健康志愿者的左房内径(LA)、左室内径(LV)、室间隔厚度(IVSd)、左室后壁厚度(LVPWd)、左室短轴缩短率(FS)、左室射血分数(EF); STI测得两组左心室各节段的左室收缩期峰值应变率(SRs)、左心室整体纵向应变(GLS)、整体圆周应变(GCS)、整体径向应变(GRS)。结果:心衰组反映左心室结构及功能的常规超声心动图所测得的指标与正常对照组相比,除了LA具有统计学意义(P<0.05),LV、IVSd、LVPWd、FS、EF均无统计学意义(P≥0.05);心衰组各节段VVI曲线图与正常对照组相比杂乱无章,运动方向及幅度不一致;心衰组经STI测得左心室各节段SRs、左心室GLS、GCS、GRS与正常对照组相比差异均有统计学意义(P<0.05)。结论:STI联合VVI对左室收缩功能的改变较LVEF敏感,能够在左室收缩功能受损早期及时发现左室功能异常。

Objective:To assess the clinical value of velocity vector imaging(VVI)combined with speckle tracking imaging(STI)in evaluation of the left ventricular systolic function in patients with chronic heart failure.Methods:Conventional echocardiography was performed in 50 patients with chronic heart failure in gradeⅢ-IV by NYHA cardiac function classification and EF≥50%by Simpson bi-plane measurement,and in another 40 healthy volunteers.Indexes measured included inner diameters of left atrium(LA)and left ventricle(LV),interventricular septum thickness(IVSd),left ventricular posterior wall thickness(LVPWd),left ventricular fractional shortening(FS)and left ventricular ejection fraction(EF).STI was used to measure the left ventricular systolic peak strain rate(SRs),left ventricular longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain(GRS).Results:LV,IVSd,IVPWd,FS and EF remained insignificant between healthy subjects and patients of heart failure except for LA(P≥0.05).The velocity vector plot of each segment of left ventricle was disorganized,and motion direction and motion range was inconsistent in heart failure patients.STI indicated difference between groups in SRs,GLS,GCS and GRS(P<0.05).Conclusion:Velocity vector imaging combined with two-dimensional speckle tracking is more sensitive to the changes in left ventricular systolic function than LVEF,and can detect the impaired left ventricular systolic function in early stage.