超声斑点追踪显像评价左心室心肌致密化不全患者心肌功能

摘要

目的 应用超声斑点追踪显像技术(STI)定量评价左心室心肌致密化不全(LVNC)患者左心室心肌纵向收缩功能,并探讨其在LVNC诊断中的价值.方法 LVNC患者21例,分为两组:LVNC-1组(n=10):LVEF≥50%;LVNC-2组(n=11):LVEF<50%.以21名年龄性别相匹配的健康志愿者作为正常对照组.采集左心室心尖长轴动态图像,利用STI获取各节段心肌纵向应变(LS)曲线及收缩期峰值应变.结果 LVNC-2组左心室各水平LS均较正常对照组明显减低(P均<0.05),但其E'、E/E'与正常对照组无明显差异.取左心室心尖段LS均值-20.71%为界值,诊断LVNC患者左心室纵向收缩功能减低的敏感度和特异度为95.00%、100%;整体LS均值-17.90%为界值,其敏感度和特异度与LS相同.结论 应用超声STI技术可对LVNC患者左心室心肌功能进行深入定量评价.%Objective To evaluate longitudinal left ventricular systolic function in patients with left ventricular noncompaction (LVNC) with speckle tracking imaging (STI). Methods Twenty-one patients with LVNC and twenty-one age/sex-matched controls (control group) were enrolled. LVNC patients were divided into two groups: LVNC-1 group (LVEF ≥50％, n=10) and LVNC-2 group (LVEF＜50％, n=11). For STI, apex long-axis dynamic image of left ventricular were acquired. Curves and peak values of systolic longitudinal strain (LS) were obtained. Results Comparing with control group, LS of all level were significantly reduced (all P＜0. 05), LVEF, PWD E and E/E were significantly different in LVNC-2 group (all P＜0. 05). In contrast, LS reduced (all P＜0. 05), however, PWD E and E/E' were not significantly different in LVNC-1 group. With an optimal cutoff value of LS was -20. 71％, and the sensitivity and specificity was 95.00％ and 100％, respectively. With an optimal cutoff value of globe LS was -17.90％, the sensitivity and specificity were the same as LS. Conclusion STI can quantitatively evaluate left ventricular function in the patients with LVNC.