运用二维斑点追踪成像技术评价健康人左心室容积与室壁节段纵向应变的时空关系

摘要

Objective To evaluate the coupling relationship between segmental longitudinal strain and left ventricular volume at different phases of the cardiac cycle by two dimensional speckle tracking imaging. Methods 2D grey scale images of 41 healthy adults were acquired,and time curve of left ventricular volume (LVV),segmental longitudinal strain(LS)and segmental longitudinal strain rate(LSr)were outputed by analysis software.The correlations between LVV and LS or LSr in isovolumic relaxation time(IVRT),the rapid filling time(RFT),the atrial filling time(AFT)and the ejection time(ET)were analyzed respectively. Results ①IVRT:LS in basal segment,middle segment,apical segment of interventricular septum,in apical segment,basal segment of the lateral wall,and in middle segment of inferior wall were low-moderate negatively correlated with LVV;only LSr in middle segment of anterior wall was negatively correlated with LVV(P0.05).② RFT:LS in middle segment,apical segment of interventricular septum,in apical segment of the lateral wall were negatively correlated with LVV;LSr in basal segment,middle segment, apical segment of interventricular septum,in apical segment,middle segment,basal segment of lateral wall, in middle segment,basal segment of inferior wall were low-moderate negatively correlated with LVV(P 0.05).③AFT:LS in basal segment of inferior wall,in apical segment,basal segment of the anterior wall were low negatively correlated wtih LVV(P 0.05).④ET:LS in basal segment,middle segment,apical segment of interventricular septum,in apical segment,basal segment of the lateral wall were low negatively correlated with LVV(P 0.05);only LSr in apical segment of lateral wall was negatively correlated with LVV(P0.05).Conclusions LS or LSr in special segments of interventricular septum,lateral wall, anterior wall and posterior wall are actively participate in the volume change of the left ventricle in healthy adults,specific myocardial segments of left ventricular wall are involved in left ventricular volume changes.%目的 运用二维斑点追踪成像技术评价左心室容积-心肌应变的时空关系.方法 获取41例健康成年人二维动态灰阶图像,通过分析软件得到左心室容积 (LVV)、节段纵向应变 (LS)、节段纵向应变率 (LSr)的时间曲线.分别将等容舒张期、快速充盈期、房缩充盈期及射血期的 LVV 与LS、LSr进行相关性分析.结果 ①等容舒张期:LVV 与室间隔基底段、中间段、心尖段、侧壁心尖段、基底段、下壁中间段的LS呈低-中度负相关,仅与前壁中间段LSr呈负相关 (均P 0.05);②快速充盈期:LVV与室间隔中间段、心尖段、侧壁心尖段 LS呈负相关,与室间隔基底段、中间段、心尖段、侧壁心尖段、中间段、基底段、下壁基底段、中间段 LSr呈明显低-中度负相关 (均P 0.05);③房缩充盈期:LVV仅与下壁基底段、前壁心尖段、基底段LSr呈低度负相关 (均P 0.05);④射血期:LVV与室间隔基底段、中间段、心尖段、侧壁心尖段、基底段 LS呈低度负相关,仅与侧壁心尖段 LSr呈负相关 (均P 0.05).结论 健康人左心室室间隔、左室侧壁、前壁及后壁特定节段LS和LSr与左心室舒张期和收缩期容积变化密切相关,提示左心室壁特定心肌节段参与心室容量变化.