摘要
目的 应用实时三维超声心动图（RT-3DE）和斑点追踪显像技术（STI）评价心肌梗死患者左心室收缩同步性.方法 采集25例正常对照者和30例心肌梗死患者左心室短轴观和心尖位四腔观、二腔观的二维灰阶及经胸实时三维超声心动图.应用Qlab 6.0脱机软件,通过RT-3DE分析,获取左心室17节段容积-时间曲线,计算16节段达到最小收缩容积时间的标准差（Tmsv-16-SD）和最大差值（Tmsv-16-Dif）,以Tmsv-16-SD大于正常对照组测定指标的单侧99%上限值判定为存在左心室收缩不同步.应用STI测量左心室短轴观各节段收缩期径向应变达峰时间（TRs）,计算左心室整体径向应变达峰时间的标准差（TRS-SD）和最大差值（TRS-Dif）,以左心室短轴观前间壁和后壁的径向应变的达峰时间之差（TAS-POST）≥130 ms作为左心室收缩不同步标准.结果 心肌梗死组各收缩同步性参数均显著大于正常对照组（均P＜0.01）.Tmsv-16-SD与TRS-SD、Tmsv-16-Dif与TRS-Dif呈中等相关（r分别为0.675和0.620,均P＜0.01）.RT-3DE和STI对心肌梗死组左心室收缩不同步的检出率无显著差异（P=0.125）,但检测一致性一般（Kappa=0.60）.结论 RT-3DE和STI技术能够评价心肌梗死患者左心室心肌收缩同步性,两种方法 所测的对应参数相关性不高,且目前对于左心室收缩同步性评价尚缺乏统一标准,因此临床应采用多方法 、多指标综合评价心肌梗死患者左心室收缩同步性.
Objective To assess the left ventricular （LV） systolic synchrony in patients with myocardial infarction using real-time three dimensional echocardiography（RT-3DE） and speckle tracking imaging（STI）. Methods Twenty-five healthy subjects and thirty patients with myocardial infarction underwent two-dimensional echocardiography and RT-3DE examination. The systolic synchrony parameters derived from RT-3DE were the dispersion of time and the maximum difference of time to minimum regional volume for 16 LV segments （Tmsv-16-SD and Tmsv-16-Dif）. When the Tmsv-16-SD was above the percent 99 of the control group distribution in patients with myocardial infarction were considered statistically different from those in the control group and were accordingly classified as LV systolic asynchrony. The time from the onset of QRS complexes to systole peak strain from the radial vectors was recorded using STI. The standard deviation and the maximal temporal difference of the radial （TRS-SD and TRS-Dif） of 18 segments were calculated as indicator of LV systolic synchrony. LV systolic asynchrony was defined as an interval≥130 ms for the absolute difference in time to peak radial strain for the anteroseptal wall versus the posterior wall （TAS-POST）. Results All the systolic synchrony parameters derived from RT-3DE and STI were significantly larger in the myocardial infarction group than those of the control group （all P〈0.01 ）.For Tmsv-16-SD and Tmsv-16-Dif,a moderate correlation with TRS-SD and TRS-Dif（ r = 0.675 and 0.620,all P〈0.01） was found. No significant difference and general consistency were found between the systolic asynchrony parameters by RT-3DE and STI （ P = 0.125, Kappa = 0.60）. Conclusions RT-3DE and STI provide effective tools to assess the LV systolic synchrony. There is no obvious correlation between these methods, thus it is essential of using different methods and parameters to evaluate the LV systolic synchrony.
出处
《中华超声影像学杂志》
CSCD
北大核心
2011年第2期97-100,共4页
Chinese Journal of Ultrasonography
关键词
超声心动描记术
实时三维
心肌梗死
心室功能
左
斑点追踪显像
Echocardiography, real-time three-dimensional
Myocardial infarction
Ventricular function, left
Speckle tracking imaging
作者简介
通信作者：郭瑞强，Email：ruiqiangwhrm@hotmail．com
