二维及三维斑点追踪技术评估左心耳封堵术患者左心功能的对比研究

Evaluation of left heart function in patients with left atrial appendage occlusion by two-and three-dimensional speckle tracking imaging:a comparative study

目的对比分析二维及三维斑点追踪(2D-STE、3D-STE)技术评价左心耳封堵术后患者左房功能与左室整体应变的价值。方法选取于我院行左心耳封堵术的非瓣膜性心房颤动(以下简称房颤)患者106例,均行常规超声心动图、2D-STE和3D-STE检查,比较术前及术后2 d、1个月、3个月、6个月各检查参数的差异。结果常规超声心动图检查结果显示,106例患者术后各时间点左室舒张末期内径、左室收缩末期内径、左室舒张末期容积、左室收缩末期容积、每搏量、左室射血分数等指标与术前比较,差异均有统计学意义(均P<0.05)。2D-STE检查结果显示,术后1个月、3个月、6个月左室17节段纵向应变(LS)、环向应变(CS)、径向应变(RS)均高于术前及术后2 d,差异均有统计学意义(均P<0.05)。3D-STE检查结果显示,术后1个月、3个月、6个月LS、CS、RS均高于术前及术后2 d,差异均有统计学意义(均P<0.05);术后3个月高于术后1个月,术后6个月高于术后1个月和3个月。2D-STE与3D-STE检查结果比较显示,术前及术后2 d、1个月、3个月、6个月LS、CS、RS比较,差异均有统计学意义(均P<0.05)。结论3D-STE技术对左心耳封堵术后患者左房功能与左室整体应变评价效果优于2D-STE,能更准确地评估患者术后各时间点左室整体应变。

Objective To comparatively analyze the value of two-and three-dimensional speckle tracking imaging(2D-STE,3D-STE)in the evaluation of left atrial function and left ventricular global strain after left atrial appendage occlusion.Methods Totally 106 patients with nonvalvular atrial fibrillation who underwent left atrial appendage occlusion in our hospital were selected,they were examined by 2D-STE,3D-STE and conventional ultrasound.The differences of parameters before surgery and 2 d,1 month,3 months and 6 months after surgery were analyzed.Results The results of conventional echocardiography showed that there were statistically significant differences in the indexes of left ventricular end-diastolic diameter,left ventricular end-systolic diameter,left ventricular end-diastolic volume,left ventricular end-systolic volume,stroke volume,left ventricular ejection fraction in 106 patients at different time points(all P<0.05).The results of 2D-STE showed that the left ventricular 17-segment longitudinal strain(LS),circumferential strain(CS),and radial strain(RS)at 1 month,3 months and 6 months after surgery were higher than those before and 2 d after the surgery,the differences were statistically significant(all P<0.05).The results of 3D-STE showed that LS,CS and RS at 1 month,3 months and 6 months after surgery were higher than those before and 2 d after surgery,the differences were statistically significant(all P<0.05).There were significant difference of the indexes between the differenct time point after surgery(all P<0.05).The comparison of 2D-STE and 3D-STE showed that there were statistically significant differences in LS,CS,RS before and 2 d,1 month,3 months,6 months after surgery(all P<0.05).Conclusion The evaluation effect of 3D-STE technique on left atrial function and left ventricular global strain after left atrial appendage occlusion is better than 2D-STE.