斑点追踪成像技术对不同左室舒张功能状态下左室节段心肌舒张功能的研究

摘要

Objective To analyze the segment myocardial strain rate in patients with different states of left ventricular (LV)diastolic function by speckle tracking imaging(STI),and to explore the relationship between segment diastolic function and global diastolic function. Methods One hundred and thirty cases with different state of LV diastolic function were enrolled. According to the international guidance about evaluation of left ventricular diastolic function published in 2009,the subjects were divided into three groups:45 cases with normal diastolic function(group A),40 cases with compliance reduced(group B)and 45 cases with sham normalization(group C).The early speak diastolic strain rate(ESR)and late speak diastolic strain rate(ASR)of 17 myocardial segments were analyzed by STI,then their difference were compared.Results ESRand ASRcomparison of basal segment, middle segment and apical segment among groups,the significant difference was found between group B and group A,group C and group A(all P<0.05),there was no significant difference between group B and group C.Comparison of ESRin 17 segments among groups,there were 6 segments of myocardium between group B and group A with statistical significance(all P<0.05),and 10 segments of myocardium between group C and group A with statistical significance(P<0.05).Comparison of ASRin 17 segments among groups,there were 3 segments of myocardium between group B and group A with statistical significance(all P<0.05),but there was no significant difference between other groups. Conclusion STI is helpful for early detection of diastolic dysfunction in segmental myocardia.With the deterioration of LV diastolic function,the ESRof more segment myocardia decreased.%目的 应用斑点追踪成像(STI)技术分析不同舒张功能状态下左室节段心肌的应变率,探讨心肌节段舒张功能与整体舒张功能的关系.方法 选取经超声心动图检查为不同舒张功能状态的体检者130例,根据2009年美国超声心动图学会指南对左室舒张功能的分级标准,将其分为舒张功能正常组45例(A组)、顺应性减低组40例(B组)及假性正常化组45例(C组).STI分析各组左室17个节段心肌舒张早期峰值应变率(ESR)、舒张晚期峰值应变率(ASR)的变化,并对其进行比较分析.结果 B、C组基底段、中间段、心尖段ESR与A组比较差异均有统计学意义(均P<0.05),B组与C组比较差异无统计学意义;各组间17个节段ESR比较,B组与A组间有6个节段心肌的ESR差异均有统计学意义(均P<0.05);C组与A组间有10个节段心肌的ESR差异均有统计学意义(均P<0.05).B、C组中间段、心尖段ASR与A组比较,差异均有统计学意义(均P<0.05),B组与C组比较差异无统计学意义;各组基底段ASR比较差异均无统计学意义;各组间17个节段ASR比较,B组与A组间有3个节段心肌的ASR差异均有统计学意义(均P<0.05);其他组间所有节段心肌ASR比较差异均无统计学意义.结论 STI技术有助于早期发现左室节段心肌的舒张功能受损;随着舒张功能持续恶化,更多的节段心肌出现ESR降低.