孤立性心肌致密化不全的心肌运动速度及同步性研究

摘要

目的 应用定量组织速度成像技术(QTVD研究孤立性心肌致密化不全(INVM)患者左室心内、外膜下心肌运动速度、比值及心肌收缩及舒张同步情况.方法 48例心肌致密化不全患者,其中24例左室舒末内径(LVEDD)正常,左室收缩功能良好,24例LVEDD增大,存在不同程度的左心功能不全.采集心尖四腔、两腔、心尖左室长轴切面QTVI图像,记录QTVI曲线心内、外膜下心肌的运动速度、比值及各期达峰时间,并以24例健康志愿者为对照.结果 INVM 1组病变节段及INVM 2组各节段心内、外膜下心肌运动速度、比值不同程度减低,各峰达峰时间不同程度延长,且其最大差及标准差均增大.结论 INVM患者各室壁运动规律受到破坏,存在明显的收缩及舒张不同步,且与病变节段及心功能相关.%Objective To investigate the endocardial velocity, epicardial velocity, ratio and systolic and-diastolic synchrony of left ventricular(LV) in patients with isolated noncompaction of ventricular myocardium(INVM) by quantitative tissue velocity imaging (QTVI). Methods 48 patients with INVM including 24 with normal LV end-diastolic diameter(LVEDD) and 24 with increased LVEDD and gradual cardiac dysfunction and 24 normal controls were studied by QTVI. The curve and value of tissue velocity imaging at the LV apical long axis, apical two-champer and fourchamloer views were obtained. Results The endocardial velocity,epicardial velocity,ratio in the patho-logical segment of INVM1 and all the segment of INVM2 decreased gradually. Relatively, the time to peak velocity increased gradually,with the maximal difference and standard deviations significantly increased. Conclusions The ventricular wall motion pattern was destroyed in patients with INVM with extremely significant LV systolic and diastolic mechanical asynchrony. The results is associated with the pathological segment and cardiac function.