摘要
目的探讨严重心力衰竭患者的心脏非同步性运动特点。方法对正常对照组30例及严重心力衰竭患者34例,应用组织同步成像(TSI)技术分析心尖四腔心、二腔心和心尖左心室长轴切面12节段(6个基底段,6个中间段)的收缩期达峰值时间(Tp)和峰值速度(Vp),并进行统计学分析。结果与对照组相比病例组Tp值增加,Vp值降低(P<0.01)。室内延迟节段数统计结果显示,正常对照组共360个节段,有321个节段(89.2%)TSI图像表现为均一的绿色,有39个节段(10.8%)表现为淡黄色,没有红色节段,其中39个淡黄色节段多发生于后壁和侧壁(59%);病例组共408节段,TSI图像颜色较紊乱,192个节段(47.1%)为绿色,127个节段(31.1%)为黄色,89个节段(21.8%)为红色,延迟节段中以侧壁多见,其次为后壁和下壁。结论TSI能定量分析室壁运动是否延迟及延迟时间,是目前评价心室运动非同步性的最佳方法,并将应用于心脏再同步化治疗(CRT)的病例选择,指导起搏器植入及术后评价等。
Objective To evaluate the characteristics of asynchronous myocardial contraction in patients with severe heart failure using tissue synchronization imaging (TSI). Methods There were 34 cases in the patient group and 30 cases in the control group. Apical 4-chamber view, apical 2-chamber view and long axis of left ventricular view were obtained using TSI in GE Vivid 7 to observe 12 segments in these views (6 basal segments, 6 mid-segments). Time to peak (Tp) and peak velocity (Vp) were measured and analyzed statistically. Results There was significantly difference in Tp and Vp between the two groups (P<0.01).The contral group included 360 segments, in which 321 segments were green (normal), 39 segments (yellow moderately-delayed) and on no red one (severely-delayed). There were 408 segments in the patient group, TSI became disordered in which 192 segments were green ,127 segments (yellow) and 89 segments (red). The delayed segments mainly located in lateral and posterior wall. Conclusions TSI is a new technology, which can analyze the movements of the ventricular wall qualitatively and quanfitatively with rapid and precise judgement whether the movement is delayed. It is the optimal modelity to evaluate the characteristics of asynchronous myocardial contraction. TSI is important to prospectively select patients indicating for cardiac resynchronization therapy (CRT), as well as to guide implantation and to evaluate post operation.
出处
《中华医学超声杂志（电子版）》
2007年第2期79-82,共4页
Chinese Journal of Medical Ultrasound(Electronic Edition)
基金
高等学校博士点科研基金(20060025001)
北京市优秀人才基金(2005ID0300619)
