实时三维斑点追踪成像对扩张型心肌病患者左室收缩功能的研究

摘要

目的：探讨实时三维斑点追踪成像（RT3D-STI）评价扩张型心肌病患者的左室收缩功能的临床价值。方法扩张型心肌病（DCM组）患者30例，体检健康者30例为对照组，实时三维超声心动图采取心尖全容积成像，分别测量左室舒张末容积（LVEDV）、收缩末容积（LVESV）及射血分数（LVEF）；RT3D-STI测量左室整体长轴应变（GLS）、整体轴向应变（GCS）、整体径向应变（GRS）及整体面积应变（GAS）。测定血浆脑钠肽（BNP）水平，分析其与左室收缩功能参数的相关性。结果①DCM组LVEDV、LVESV及血浆BNP均高于对照组，LVEF低于对照组（均P＜0．05）。②DCM组LVEF、GLS、GCS、GRS、GAS与血浆BNP水平均呈负相关，其中GAS与血浆BNP水平相关性最高，LVEF次之（r分别为-0．829、-0．705，P＜0．05）。③DCM组GLS、GCS、GRS、GAS均较对照组减低（P＜0．05），GLS、GCS、GRS及GAS与LVEF均具有较好相关性，其中GAS与LVEF相关性最高。④DCM组左室中间段GLS、GCS、GRS、GAS均高于基底段及心尖段（P＜0．05）。结论 RT3D-STI能够无创、简便、准确地评价DCM患者的左室收缩功能。%Objective To explore the clinical value of real-time three-dimension speckle tracking imaging(RT3D-STI)in evaluating the left ventricular systolic function of patients with dilated cardiomyopathy(DCM). Methods Thirty control subjects and thirty patients with DCM were involved. The apical full volume imaging technology was applied in real-dimension echocardiography . The left ventricular end-diastolic volume(LVEDV),end-systolic volume(LVESV) ,ejection fraction (LVEF),left ventricular global longitudinal strain(GLS),left ventricular global circumferential strain(GCS),left ventricular global radial strain(GRS)and left ventricular global area strain(GAS)were measured by RT3D-STI,respectively. In addition, the plasma brain natriuretic peptide(BNP)levels were determined and correlatively analyzed with the index of left ventricular systolic function. Results Compared with control group,the LVEDV,LVESV and BNP were significantly increased,but the LVEF was decreased in DCM group(P<0.05). The LVEF,GLS,GCS,GRS and GAS were negatively correlated with BNP in DCM group. The correlation between GAS and BNP was the highest,followed by LVEF(r=-0.829,-0.705). Compared with control group,GLS,GCS,GRS and GAS were significantly decreased in DCM group(P<0.05). GLS,GCS,GRS and GAS were correlated well with LVEF in DCM group. Among them,GAS has the best correlation with LVEF. In the DCM group,left ventircular middle section of the GLS,GCS,GRS and GAS were higher than the basal and apical segment(P<0.05). Conclusion RT3D-STI can evaluate the left ventricular systolic function of patients with DCM with advantages of noninvasiveness,convenience and accuracy.