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|本期目录/Table of Contents|

四种超声心动图技术评价正常人心肌生物力学参数及其与心功能相关关系

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:
2013年第1期
页码:
85-089
栏目:
临床研究
出版日期:
2013-02-25

文章信息/Info

Title:
Study of normal myocardial biomechanical parameters and their relationship with cardiac functions using multimodality echocardiographic techniques
作者:
周绮平1; 李玉婵1; 欧阳斯华1; 黄尧垚1; 王良玉1; 谢明星2
(1.中山大学附属汕头医院超声科，广东 汕头515031；2. 华中科技大学同济医学院附属协和医院超声影像科，湖北 武汉 430022)
Author(s):
ZHOU Qiping1;  LI Yuchan1;  Ouyan Sihua1;  HUANG Yaoyao1;  WANG Liangyu1;  XIE Mingxing2
(1.Department of Ultrasonic Diagnosis, Affiliated Shantou Hospital, Sun Yatsen University, Guangzhou 515031, Guangdong, China; 2.Department of ultrasonography, Union Hospital of Tongji Medical college, Huazhong niversity of science and technology, Wuhan
关键词:
直接二维测量法; 二维斑点追踪技术; 解剖M型; 组织速度成像技; 应变; 应变率显像; 心功能
Keywords:
congenital heart disease;  secondary pulmonary hypertension;  surgery
分类号:
R540.45；R331.31
DOI:
-
文献标识码:
A
摘要:
目的: 比较直接二维测量法(D2D)、解剖M型(AMM)、组织速度成像技术(TVI)及二维斑点追踪技术(STI)评价正常人心肌生物力学参数及其与心功能相关关系的方法，比较他们在临床运用过程优点及存在问题。方法： 分别应用D2D、AMM、TVI及STI测量并比较40例正常人收缩、舒张期心肌在长轴方向、短轴和圆周方向的心脏生物力学参数。结果： D2D显示：正常人收缩期纵向应变(LS)及应变率(LSR)：下壁>后间隔>前间隔>后壁>前壁>侧壁（P>005）；收缩期LS、LSR与左室射血分数（LVEF）相关系数(r)分别为-0523及-0550。AMM显示：正常人收缩末期径向应变(RS)及径向应变率(RSR)游离壁大于间隔：收缩期RS、RSR与左LVEF(r)分别为0533及0495。TVI显示：收缩期LS：心尖段<基底段、中间段(P<005)；舒张早期LS中间段>基底段>心尖段；舒张晚期LS心尖段<基底段、中间段(P<005)；收缩期LS、LSR与LVEF(r)分别为-0562及-0550。STI显示：收缩期LS从基底段到心尖段逐步递增；左室扭转运动表现为心底部顺时针旋转和心尖部逆时针旋转，心脏整体表现为心动周期内逆时针方向为主的扭转运动。心肌收缩期平均LS及LSR与左室收缩功能参数间r的绝对值均超过055。结论： D2D通过直接测量左室长轴方向心肌长度的变化，间接计算LS与LSR；AMM克服了M型超声测量的角度限制，比较适合体位不合作的患者；TVI适合评价长轴方向室壁运动特征；STI对二维图像的超声斑点回声进行逐帧追踪，可以更准确测量局部室壁V、S等参数，定量评价局部心肌的收缩和舒张功能，测量参数与传统超声测量LVEF相关性较好，但设备要求较高。
Abstract:
AIM:To study the surgical treatment of patients with congenital heart disease (CHD) with severe pulmonary hypertension (PH). METHODS: One-way valved patch was used during surgical treatment for 48 patients with CHD with PH. Patients included represented 30 cases of ventricular septal defect (VSD), three cases of atrial septal defect (ASD), eight cases of VSD with ASD, and seven cases of VSD with patent ductus arteriosus (PDA). RESULTS: One patient died postoperatively due to low cardiac output syndrome. All patients suffered from hypoxia postoperatively. After the first postoperative week, transpatch shunt was observed in 40 patients and after 3 postoperative months, open valves were seen in ten cases. Twenty-six months postoperatively, valves closed and shunting disappeared. Transcutaneous oxygen was >95% and pulmonary artery pressure decreased significantly. CONCLUSION: Application of one-way valved patch in surgical treatment of congenital heart disease with pulmonary hypertension enhances the rate of successful surgeries and more rapid recovery.

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备注/Memo

备注/Memo:
收稿日期：2012-06-25.通讯作者：王良玉，主任医师，主要从事心血管超声诊断Email:13902747408@139.com 共同通讯作者：谢明星，教授， 主要从事心血管超声诊断和分子影像学新技术研究Email:xiemx64@126.com 作者简介：周绮平，住院医师，硕士Email:13750498429@139.com
更新日期/Last Update: 2013-03-20