二尖瓣环自动追踪技术评价风湿性二尖瓣狭窄患者左室收缩功能的研究

摘要

Objective To evaluate the clinical application of automated mitral annular tracking (AMAT) for assessing left ventricular systolic function in patients with rheumatic mitral stenosis(MS). Methods 30 patients with MS and 30 healthy controls were studied. Apex-max angle(Angle max ), Apex-min angle( Anglemin ), angle difference between Apex-max and Apex-min(△Angle), the difference of systolic left ventricular length of long axis(△Length), the difference of systolic distance from Apex to septal and lateral sites of mitral annul us(△Apex-s, △Apex-1), systolic mitral annular displacement of septal and lateral sites of mitral annulus(Ds-s, Ds-1) were measured by AMAT. The difference of the parameters between the patient group and the control group were analysed. Meanwhile, Ds-s, Ds-1 were measured by M-mode echocardiography. Results Angle max ,Ange min, △Length , △Apex-s , △Apex-1 ,Ds-s,Ds-1 were significantly lower in the patients with MS than those of controls(P＜0.01); And all variables were different in the patients with mild,moderate and severe MS(P＜0. 05). There were no significant differences in Ds-s,Ds-1 between AMAT and M-mode(P＞0.05). Conclusions AMAT can early detect ventricular apex movement and left ventricular systolic function in patients with MS.%目的 应用二尖瓣环自动追踪技术(AMAT)评价风湿性二尖瓣狭窄(MS)患者左室收缩功能.方法 选取MS患者30例(按二尖瓣狭窄程度分为轻、中、重度组)和健康志愿者30例,取心尖四腔心,采用AMAT测量心尖摆动最大角度、最小角度、角度差、左心室收缩期长轴长度的改变、心尖与二尖瓣环之间间隔侧及侧壁处收缩期距离的改变、二尖瓣环间隔侧及侧壁处的收缩期位移.同时采用M型超声测量二尖瓣环间隔侧及侧壁处收缩期位移.结果 MS患者的心尖摆动最大角度、最小角度、左心室收缩期长轴长度的改变、心尖与二尖瓣环之间间隔侧及侧壁处收缩期距离的改变、二尖瓣环间隔侧及侧壁处的收缩期位移测值均较健康对照组测值减小(P＜0.01),且轻、中、重度组间相互比较有统计学差异(P＜0.05).AMAT和M型超声测量的二尖瓣环间隔侧及侧壁处收缩期位移无统计学差异(P＞0.05).结论 AMAT可以测量MS患者的心尖摆动、左室长轴运动变化参数来评价MS患者的左室收缩功能,为MS患者左心功能评价提供了新方法.