摘要
目的探讨二维斑点追踪应变成像技术评价冠心病患者左室同步性的临床价值。方法42例急性心肌梗死患者、39例冠心病心肌缺血患者和32例对照者接受二维超声检查，用二维应变软件分析心尖长轴观、心尖两腔观和四腔观以及左室短轴观基底水平、乳头肌水平、心尖水平的图像，测量自心电图QRS波起点至左室在心尖长轴观上的收缩期纵向应变达峰时间（Tssl）及胸骨旁短轴观上的收缩期径向和环向应变达峰时间（Tssr，Tssc）。计算左室各节段达峰时间标准差（Tssl—SD，Tssr-SD，Tssc—SD）及节段达峰时间最大差值（Tssl—Dif，Tssr-Dif，Tssc—Dif），以左室短轴观乳头肌水平前室间隔和后壁的径向应变的达峰时间之差（TTAS-POST）≥130ms作为左室收缩不同步标准，同时测量18个心肌节段纵向应变峰值与收缩末应变的差值之和作为纵向应变延迟指数（LSDI），LSDI≥25％作为左室不同步标准。结果急性心肌梗死组同步性参数较对照组增加（P〈0．001或P〈0．05）；心肌缺血组同步性参数较对照组增高（P〈0．05）；LSDI与TAS-POST呈正向线性相关（r=0．676，P〈0．05）；急性心肌梗死组中，LSDI检测左室不同步敏感性高于TAS-POST（P〈O．05）。结论二维斑点追踪应变成像技术能准确评价左室不同步性，LSDI与TAS-POST可定量评价冠心病患者左室不同步性。
Objective To assess the clinical values of the longitudinal strain delay index（LSDI） and the delay of time in peak anterospetal wall to posterior wall strain（TAS-POST）, which are analyzed by speckle tracking imaging, was discussed in the article. Methods The study included 39 patients with acute myocardial infarction,37 patients with coronary heart disease but not acute myocardial infarction which was confirmed by selective coronary angiography and 30 age-gender-related volunteers. Two-dimensional echocardiography was performed to collect dynamic images of left ventricular apical long axis view, two- chamber view, four-chamber view and parasternal short axis mitral view, papillary view and apical view. The time to minimal systolic longitudinal, radial, circumferential strain （Tssl, Tssr and Tssc） were measured from the start point of QRS wave of electrocardiogram. The left ventricular segmental standard deviation （TssI-SD,Tssr-SD, Tssc-SD） and maximal difference （Tssl-Dif, Tssr-Dif, Tssc-Dif） were calculated. The left ventricular dyssynchrony was defined as TAS-POST≥130 ms and LSDI≥25%. Results The dyssynchrony parameters in the acute myocardial infarction group were significantly increased compared to the control group （ P 〈0. 001 or P d0.05 ）. The parameters in the myocardial ischemia group were also higher than those in the control group （ P 〈0.05）. Linear regression showed that LSDI was positive correlated with TASPOST（ r = 0. 676, P 〈0.05）. In acute myocardial infarction group, LSDI was more sensitive in the detection of left ventricular dyssynchrony than TAS-POST （P 〈 0.05 ）. Conclusions dyssynchrony can be evaluate accurately by speckle tracking imaging. LSDI and TAaPOST parameters for the evaluation of left ventricular dyssynchrony in coronary heart disease. Left ventricular are quantitative
出处
《中华超声影像学杂志》
CSCD
北大核心
2012年第6期470-473,共4页
Chinese Journal of Ultrasonography
