速度向量成像技术评估单心室纵向收缩功能

摘要

Objective To investigate the longitudinal systolic ventricular function of children with single ventricle, and to appraise the feasibility and clinical value of velocity vector imaging (VVI) on assessing it. Methods The study group consisted of 30 patients with functional single ventricle. The control group consisted of 30 age- and gender-matched normal children. Using Sequoia C512 echocardiography machine,the peak velocity(V),peak displacement(D) ,strain(S) ,and strain rate(SR) were measured. Results Basel and median velocities,as well as basel and median displacements of rudimentary chamber side(RCS), were lower than those of septum[Basel velocity (1. 93 ± 0. 71)cm/s vs (3. 53 ± 1. 07)cm/s;Median velocity (1.19±0. 57)cm/s vs (2. 03 ± 0. 90) cm/s; Basel displacement (2. 53 ± 1.65) mm vs (6.21 ± 2. 12)mm;Median displacement(1. 26 ± 1. 06)mm vs (3. 21 ± 1.37)mm]. The values of strain of all the six segments of single ventricle were significantly lower than Corresponding segments of the control group [ basel nonrudimentary chamber side(NRCS) ( - 16. 17 ± 4. 37) % vs ( - 19. 66 ± 3. 47) % ; Median NRCS ( - 15. 23 +4.36)% vs (-19.64± 4. 75)%; Apical NRCS (-13.84 ± 5.79)% vs ( - 16. 7 ± 4. 15)%; Basel RCS(-10. 54±5.35)% vs (-19.49±3. 74)%;Median RCS ( - 10. 16 ± 5. 26)% vs ( -20. 83 ± 3. 82)% ;Apical RCS ( - 10. 97 ± 5. 22) % vs C - 18. 11 ± 4.43) %]. Aside from basel strain rates of NRCS, strain rates of all the other five segments of single ventricle were significantly lower than Corresponding segments of the control group [Median NRCS ( - 1. 21 ± 0. 42)s-1 vs (- 1.49 ± 0. 24)s-1 ;Apical NRCS ( - 1.10 ±0.41)s-1 vs (-1.47 ± 0.24)s-1;Basel RCS ( - 1.07 ± 0. 35) s-1 vs (- 1. 49 ± 0. 22) s-1; Median RCS (-0.97± 0.34)s-1 vs ( -1.48 ± 0. 20)s-1 (Apical RCS ( - 0. 93 ± 0. 39)s-1 vs ( - 1. 48 ± 0. 22)s-1]. Conclusions Longitudinal systolic ventricular function is impaired in children with functionally single ventricle. VVI can be used to asses ventricular systolic performance in children with functionally single ventricular.%目的 观察单心室纵向运动情况,评价速度向量成像技术(velocity Vector imaging,VVI)估测单心室患儿心室收缩功能的可行性和应用价值.方法 功能性单心室患儿30例(单心室组)及正常儿童30例(对照组)为研究对象,应用VVI技术计算心内膜的速度矢量,测量主心腔各节段的纵向收缩期峰值速度、纵向收缩位移、应变、应变率,并进行对比分析.结果 单心室残腔侧基底段与中间段速度、位移均明显低于对照组室间隔相应节段[基底段速度(1.93±0.71)cm/s对(3.53±1.07)cm/s;中间段速度(1.19±0.57)cm/s对(2.03±0.90)cm/s;基底段位移(2.53±1.65)mm对(6.21±2.12)mm;中间段位移(1.26±1.06)mm对(3.21±1.37)mm].单心室各节段应变均低于对照组相应节段[非残腔侧基底段(-16.17±4.37)%对(-19.66±3.47)%;非残腔侧中间段(-15.23±4.36)%对(-19.64±4.75)%;非残腔侧心尖段(-13.84±5.79)%对(-16.7±4.15)%;残腔侧基底段(-10.54±5.35)%对(-19.49±3.74)%;残腔侧中间段(-10.16±5.26)%对(-20.83±3.82)%;残腔侧心尖段(-10.97±5.22)%对(-18.11±4.43)%].除外非残腔侧基底段,单心室各节段应变率均明显低于对照组相应节段[非残腔侧中间段(-1.21±0.42)s-1对(-1.49±0.24)s-1;非残腔侧心尖段(-1.10±0.41)s-1对(-1.47±0.24)s-1;残腔侧基底段(-1.07±0.35)s-1对(-1.49±0.22)s-1;残腔侧中间段(-0.97±0.34)s-1对(-1.48±0.20)s-1;残腔侧心尖段(-0.93±0.39)s-1对(-1.48±0.22)s-1].结论 单心室患儿存在纵向收缩功能不全,VVI技术可以反映单心室纵向收缩功能的变化.