斑点追踪成像技术评价梗死心肌和缺血心肌对左心室局部收缩功能的影响

摘要

Objective To assess the longitudinal, radial and circumferential systolic strain ( LS , RS , CS ) and strain rate ( LSR, RSR, CSR ) from regional myocardial in patients with myocardial infarction and ischemia by speckle tracking imaging STI ) and to evaluate regional left ventricular systolic dysfunction. Methods The high frame rate two-dimensional echocardiography were performed in the 30 patients of the myocardial infarction and 25 patients of the ischemia myocardial group and 25healthy subjects. The longitudinal and radial and circumferential systolic strain ( LS,RS , CS ) and strain rate ( LSR , RSR , CSR ) from 18 regional myocardial were measured in the apical 2-chamber view.apical 4-chamber view and three level of short-axis views mitral valve, papillary muscle and cardial apex ) by STI. Results Compared with normal segments , the LS , RS, CS and LSR, RSR, CSR of ischemia segments were decreased. LS and LSR were significantly decreased from control group ( P＜0.05 ),while there were no significant differences in CS, CSR and RS, RSR ( P＞ 0.05 ).Compared with normal segments , LS , RS, CS and LSR, RSR, CSR of infarct segments were significantly decreased ( P＜0.01 ). Conclusions Regional left ventricular systolic dysfunction could be accurately analyzed by LS, RS, CS and LSR , RSR, CSR from regional myocardial in patients with infarction and ischemia myocardial by STI. LS and LSR are more sensitive than other indices in myocardial ischemia.%目的 应用超声斑点追踪成像(STI)技术分析梗死心肌及缺血心肌节段心肌纵向、径向及周向的收缩期峰值应变及应变率,评价其对左心室局部心肌收缩功能的影响.方法 35例心肌梗死患者(梗死组)、25例心肌缺血患者(缺血组)和25例正常体检者(正常组),接受超声检查,采集左心室长轴观、心尖四腔观,心尖二腔观及左心室短轴观(二尖瓣环水平、乳头肌水平和心尖水平)二维灰阶图像,按左心室18节段划分法,分析各个切面观心肌节段的纵向、径向和周向收缩期峰值应变及应变率.结果 心肌缺血组纵向收缩期峰值应变及应变率低于正常组(P＜0.05),而径向收缩期峰值应变、应变率和周向收缩期峰值应变、应变率低于正常节段,但差异无统计学意义(P＞0.05);心肌梗死组径向、周向、纵向应变及应变率均显著低于正常组节段(P＜0.01) ,也较缺血组节段低(P＜0.05).结论 超声斑点追踪成像技术能准确评价梗死心肌和缺血心肌局部运动异常,纵向应变及应变率反映心肌缺血较其他指标敏感.