超声斑点追踪成像技术评价动脉导管未闭患者左室扭转的初步研究

Assessment of Left Ventricular Twist in Patent Ductus Arteriosus Using Speckle Tracking Imaging

目的:应用超声斑点追踪成像技术定量分析动脉导管未闭(PDA)患者的左室扭转并探讨其运动同步性。方法:选取我院2009年12月—2010年6月PDA患者进行回顾性分析,将35例PDA患者分为单纯PDA组和合并肺动脉高压组(PAH组),应用超声斑点追踪成像技术测量左室短轴观心底部及心尖部旋转角度峰值及达峰时间,计算左室扭转角度峰值及达峰时间、主动脉瓣关闭时间点扭转角度及时间。并与37例正常对照组获取的上述指标进行组间比较。结果:(1)PAH组患者左室心尖部旋转角度峰值、左室扭转角度峰值及主动脉瓣关闭时间点(AVC)的扭转角度均低于单纯PDA组和正常对照组(P<0.01),而PAH组患者左室心底部旋转角度峰值与另两组无统计学差异(P>0.05)。(2)PAH组患者左室心底部旋转角度达峰时间早于主动脉瓣关闭时间,而心尖部旋转角度达峰时间及左室扭转角度达峰时间均迟于主动脉瓣关闭时间(P<0.01)。(3)单纯PDA组患者与正常对照组各指标之间的差异均无统计学意义(P>0.05)。结论:超声斑点追踪成像技术可无创地评价动脉导管未闭患者的左室扭转运动特征及左室运动的同步性。PAH组患者左室收缩功能受损,且左室运动不同步。

Objective:Ultrasonic spot tracking imaging technique was applied to quantitatively analyze the left ventricular(LV)torsion of patients with patent ductus arteriosus(PDA)and explore their motor synchronization.Methods:The PDA patients from December 2009 to June 2010 in our hospital were selected for retrospective analysis,35 patients with PDA patients were divided into two groups according to pulmonary arterial systolic pressure(PASP):the Pulmonary arterial hypertension group(PAH group)and the pure(PDA)group.The peak and peak time of the bottom and tip of the left chamber were measured by ultrasonic spot tracking imaging.Recorded and calculated the basal and apical left ventricular peak rotation(Prot),left ventricular peak twist(Ptw),twist at aortic valve closure(AVCtw)and time to Prot,Ptw and AVCtw respectively in 35 patients and 37 healthy controls,then compared the indexes above among the three groups.Results:(1)The apical left ventricular peak rotation,left ventricular peak twist and twist at aortic valve closure were lower in PAH group than pure PDA group and controls group(P<0.01),the peak of the LV bottom heart rotation angle in the PAH group was not significantly different from the other two groups(P>0.05).(2)The time to the basal LV peak rotation was earlier than aortic valve closure(AVC)timing,while the time to the apical LV peak rotation and the LV peak twist(Ptw)delayed(P<0.01).(3)There were no statistcs in all indexes between the pure PDA group and the controls(P>0.05).Conclusion:STI can measure the LV rotation and twist noninvasively and evaluate the LV synchronism in patients with PDA.Left ventricular systolic function is decreased and causes the LV dyssynchrony in PDA patients with PAH.