«上一篇/Previous Article|本期目录/Table of Contents|下一篇/Next Article»

《心脏杂志》[ISSN:1009-7236/CN:61-1268/R]

期数:

2016年第2期

页码:

197-201

栏目:

临床研究

出版日期:

2015-11-25

文章信息/Info

Title:

Assessment of left ventricular systolic function and synchrony using real-time three-dimensional echocardiolograph and two-dimensional speckle tracking imaging in patients with coronary heart disease

作者:

张小花¹; 姜志荣²; 韩素华¹; 门光明¹

（1.东营市人民医院超声科，山东 东营 257091；
2.青岛大学附属医院心脏超声科，山东 青岛 266003）

Author(s):

ZHANG Xiao-hua¹;  JIANG Zhi-rong²;  HAN Su-hua¹;  MEN Guang-ming¹

(1.Department of Ultrasound, Dongying People’s Hospital, Dongying, 257091, Shandong, China；
2.Department of Cardiac Ultrasound, Affiliated Hospital, Qingdao University, Qingdao 266003, Shandong, China)

关键词:

超声心动描记术; 三维; 斑点追踪; 二维; 心肌缺血; 心肌梗死; 左心室功能; 同步性

Keywords:

three-dimensional echocardiography;  two-dimensional Speckle tracking imaging;  myocardial ischemia;  myocardial infarction;  left ventricular systolic function;  synchrony

分类号:

R541.4

DOI:

-

文献标识码:

A

摘要:

目的 探讨实时三维超声心动图(RT-3DE)和二维斑点追踪显像 (2D-STI)评价心肌缺血和心肌梗死患者左室整体收缩功能和同步性的临床应用价值，及两种方法在评价左室收缩同步性方面的相关性。方法 46例心肌缺血患者（心肌缺血组）、44例心肌梗死患者（心肌梗死组）和60例健康志愿者（正常对照组）行RT-3DE和2D-STI检查，应用Qlab8.1软件脱机分析，获得左心室收缩功能参数：GLS、GCS、GRS、3D-LVEDV、3D-LVESV和3D-LVEF；同步性参数：Tls-l6-SD、Trs-l2-SD、Tcs-l2-SD、TAS-POST、Tmsv-l6-SD和Tmsv-16-Dif。 结果 与正常对照组比较，心肌缺血组常规超声心动图无阳性发现，2D-STI示GLS明显降低，Tls-16-SD明显延长（P<0.05）； RT-3DE“牛眼图”可见室壁运动异常的节段，Tmsv-16-SD、Tmsv-16-Dif明显延长（P<0.05）。心肌梗死组常规超声心动图、2D-STI 及RT-3DE均有阳性表现，RT-3DE与2D-STI同步性参数相关性分析示Tmsv-16-SD与TAS-POST呈正相关(r=0.574，P<0.01)，其余参数无相关性。 结论 RT-3DE与2D-STI可早期客观评价心肌缺血组冠心病患者左室收缩同步性，且二者存在一定相关性。

Abstract:

AIM To assess the clinical value of real-time three-dimensional echocardiolography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI) in evaluating left ventricular (LV) global systolic function and synchrony in patients with myocardial ischemia and myocardial infarction and to investigate the correlation of the two techniques in left ventricular synchrony. METHODS RT-3DE and 2D-STI were performed in 46 patients with myocardial ischemia, 44 patients with myocardial infarction and 60 healthy subjects (control group). Offline analysis was conducted using Qlab 8.1 to measure or calculate the parameters of systolic function (GLS, GCS, GRS, 3D-LVEDV, 3D-LVESV, 3D-LVEF) and synchrony (Tls-l6-SD, Trs-l2-SD, Tcs-l2-SD, TAS-POST, Tmsv-l6-SD, Tmsv-16-Dif). RESULTS Compared with those in the control group, no positive manifestations were found using conventional echocardiography in myocardial ischemia group. GLS significantly decreased, Tls-16-SD was significantly prolonged measured by 2D-STI (P<0.05), Tmsv-16-SD and Tmsv-16-Dif significantly increased measured by RT-3DE (P<0.05) and left ventricle regional abnormal wall motion was displayed in the bull’s-eye map of RT-3DE. Compared with those in the myocardial ischemia group and control group, conventional echocardiography, 2D-STI and RT-3DE, respectively, had positive manifestations in myocardial infarction group. Tmsv-16-SD and TAS-POST were positively correlated (r=0.574, P<0.01) but no correlation was found in other synchrony parameters. CONCLUSION 2D-STI and RT-3DE can early assess LV systolic synchrony in patients with myocardial ischemia. Tmsv-16-SD and TAS-POST are positively correlated.

参考文献/References

[1]Dhingra R,Pencina MJ,Wang TJ,et al.Electrocardiographic QRS duration and congestive heart failure:the Framing-ham Heart Study[J].Hypertension,2006,47(5):861-867.
[2]Amundsen BH,Helle-Valle T,Edvardsen T,et al.Noninvasive myocardial strain measurement by speckle tracking echocardio-graphy: validation against sonomicrometry and tagged magnetic resonance imaging[J].J Am Coll Cardiol,2006,47(4):789-793.
[3]Shimada YJ,Shiota T.A meta-analysis and investigation for the source of bias of left ventricular volumes and function by three-dimensional echocardiography in comparison with magnetic resonance imaging[J].Am J Cardiol,2011,107(1):126-138.
[4]Zhou Q,Deng Q,Huang J,et al.Evaluation of left ventricular mechanical dyssynchrony in patients with heart failure after myocardial infarction by reai-time three dimensional echocardiography[J].Saudi Med J,2012,33(3):256-261.
[5]Jonathan C,Lizelle H,Chiew W,et al.Differentiation of subendocardial and transmural infarction using two-dimensional strain rate imaging to assess short-axis and long-axis myocardial function[J].J Am Coll,2006, 48(11):2026-2033.
[6]李 燕,吕 清，王新房，等.纵向、径向及周向二维应变评价冠心病患者左心室局部收缩功能异常[J].中华超声影像学杂志,2009,18(4):277-280.
[7]Takeuchi M,Jacobs A,Sugeng L,et al.Assessment of left ventricular dyssynchrony with real-time-3-dimensional echocardiography: comparison with Doppler tissue imaging ［J］. J Am Soc Echocard iogr,2007,20(12):1321-1329.
[8]贾 妍，郭瑞强，陈金玲，等.实时三维超声心动图评价陈旧性心肌梗死患者左心室收缩同步性与收缩功能[J].中国医学影像技术,2010,260(1):75-78.
[9]Suffoletto MS,Dohi K,Cannesson M,et al.Novel speckle -tracking radial strain from routine black-and -white echocardiographic images to quantify dyssynchrony and predict response to cardiac resynchronization therapy[J].J circulation,2006,113(7):960-968.

备注/Memo

备注/Memo:

收稿日期：2015-04-24.
通讯作者：姜志荣，主任医师,主要从事心脏超声诊断研究 Email:jiangzhirong2@163.com
作者简介：张小花，副主任医师，博士生 Email:zhxhqd1969@126.com

常用功能

更新日期/Last Update: 2016-04-25