实时三平面定量组织速度成像技术与斑点追踪技术评价扩张型心肌病患者左室纵向收缩不同步性

摘要

目的应用实时三平面定量组织速度成像技术(RT-3PE QTVI)与斑点追踪技术(STI)评价扩张型心肌病患者(DCM)左室纵向收缩不同步性。方法30例正常成人为对照组,30例DCM患者为DCM组。平静状态下获取心尖四腔切面、心尖二腔切面、心尖左室长轴切面二维灰阶及RT-3PE QTVI动态图像。双平面Simpson法测量左室射血分数(LVEF)；脱机分析测量左室基底段和中间段12节段组织速度峰值(Vs)及达峰时间(Ts),左室基底段、中间段、心尖段18节段纵向应变峰值(Ls)及达峰时间(Tls),并计算其达峰时间的最大差值(Ts-diff、 Tls-diff)及其标准差( Ts-SD、Tls-SD),作为左室纵向收缩不同步运动的指标。结果① DCM组的左室舒张末内径(LVEDd)、左室收缩末内径(LVESd)、左室舒张末容积(LVEDL)、左室收缩末容积(LVESL)、LVEF及左室短轴缩短率(FS)与对照组相比,差异有统计学意义(P<0.01)。② DCM组各节段Ls及Vs明显低②对照组相应节段,差异有统计学意义( P <0.01)。与对照组比较, DCM组Tls、Ts有明显的提前或延迟,差异有统计学意义(P<0.05)。③与对照组比较,DCM患者的Ts-SD、Tls-SD、Ts-diff、Tls-diff明显增加(P<0.01)；Ts-SD、Tls-SD、Ts-diff、Tls-diff与LVEF呈负相关(r=-0.67、-0.72、-0.75、-0.77, P<0.01)。结论DCM患者存在左室纵向收缩不同步性。RT-3PE QTVI与STI联合应用对②DCM患者左室纵向收缩不同步评价,优②其中的任何一种技术。%Objective To explore left ventricular longitudinal axis systolic asynchrony by real-time triplane quanti-tativetissue velocity imaging(RT-3PE QTVI) and two-dimensional speckle tracking imaging(STI) in patients with dilated cardiomyopathy. Methods Thirty normal adults were included as the control group and thirty adults with DCM. The images from enough frame rates RT-3PE QTVI and STI were obtained from series long-axis views. Simp-son method was used to measure LVEF. Q-lab software was used to measure peak systolic tissue velocity(Vs) and peak systolic longitudinal strain (Ls),its time to peak point from each segment(Ts,Tls) and the maximal temporal difference of Ts,Tls(Ts-diff,Tls-diff),and the standard deviation of. Ts,Tls(Ts-SD,Tls-SD),which were served as systolic asynchrony indexes in assessing LV longitudinal axis systolic asynchrony. Results ① Compared the con-trol group and DCM group,there were significant differences in LVEDd,LVESd,LVEDL,LVESL,LVEF,FS (P<0.01). ② In comparison with the control group,the Ls and Vs of each segment were decreased in the DCM group (P<0.01). Compared with the control group,the parameters of Tls and Ts in DCM group had obvious ahead or de-layed(P<0.05). ③ Compared with the control group,the parameters of Ts-SD, Tls-SD, Ts-diff, Tls-diff,were significantly different in DCM group (P<0.01). Ts-SD,Tls-SD,Ts-diff,Tls-diff corrrlated negatively to LVEF(r=-0.67,-0.72,-0.75, -0.77,P<0.01). Conclusion The prevalence of left ventricular longitndinal axis systolic asynchrony exits in patients with DCM. There is a better technique to evaluate LV longitudinal axis systolic asynchrony by RT-3PE QTVI and STI than only one.