天津医药

天津医药 ›› 2016, Vol. 44 ›› Issue (3): 367-369.doi: 10.11958/59111

• 应用研究 • 上一篇    下一篇

实时三维超声和斑点追踪技术对慢性心衰患者左室再同步化治疗评价

骆永娟,关欣,朱延波   

  1. 天津市胸科医院超声科
  • 收稿日期:2015-09-17 修回日期:2015-10-25 出版日期:2016-03-15 发布日期:2016-03-15
  • 通讯作者: 骆永娟 E-mail:1219526935@qq.com
  • 作者简介:骆永娟（1974）， 女， 副主任医师， 学士， 主要从事超声研究

Assessment ofthe Efficacy of Cardiac Resynchronization Therapy Using Real-TimeThree—Dimensional Echocardiography and speckle tracking imaging in Patients with Chronic Heart Failure

LUO Yongjuan, GUAN Xin, ZHU Yanbo   

  1. Department of Ultrasound, Tianjin Chest Hospital, Tianjin 300222, China
  • Received:2015-09-17 Revised:2015-10-25 Published:2016-03-15 Online:2016-03-15
  • Contact: Yong-Juan LUO E-mail:1219526935@qq.com

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摘要： 摘要 目的 探讨实时三维超声（RT-3DE)和斑点追踪技术（STI）在慢性心衰患者左室再同步化治疗中的应用价值。方法 31例接受心脏再同步化治疗（cardiac resynchronization therapy，CRT）的慢性心衰患者分别于术前、术后3个月及6个月应用实时三维超声和斑点追踪技术测量左室舒张末期容积（LVEDV）、收缩末期容积（LVESV）左心室射血分数(LVEF)及左室内同步性。RT-3DE评价左室16节段达最小收缩容积时间的标准差及其与心电图R-R间期的比值(Tmsv-16SD%，SDI) 和最大差值(Tmsvl6Dif%)。STI评价左室16节段QRS波起点至纵向应变、径向应变和圆周应变达峰时间的标准差与心电图R-R间期的比值(Tls-l6SD%、Trs-l6SD%、Tcs-l6SD%)和对应的最大差值(T-Dif%)。结果 与术前比较术后3个月及6个月患者左心室收缩末容积、左心室舒张末容积小于术前，LVEF比术前改善。与术前比较术后3个月及6个月患者Tmsv-16SD%、Tmsvl6Dif%、Tls-l6SD%、Trs-l6SD%、Tcs-l6SD%及T-Dif%逐渐降低，差异具有统计学意义(P<0.05)，Tmsv-16SD% 、Tmsvl6Dif%、Trs-l6SD%、Tcs-l6SD%与LVEF具有良好的负相关性。结论 实时三维超声和斑点追踪技术可以准确有效地评估左心室整体、局部收缩功能及左心室同步性，为心衰患者的诊断、心脏再同步化治疗及预后评估提供更准确的定量信息。

关键词: 心力衰竭 , 超声心动描记术, 多普勒, 彩色, 心脏再同步化治疗, 实时三维超声, 斑点追踪技术

Abstract: Objective To assess the efficacy of cardiac resynchronization therapy using real-time three-dimensionsl echocflrdiography and speckle trackingimaging in patients with chronic heart failure. Methods Thirty patients with chronic heart failure were examined by RT-3DE and STI before CRT and 3，6months after CRT.Measured LVEDV、LVESV and LVEF.RT-3DE parameters were the dispersion of time to minimum regional volumefor 16 segments(Tmsvl6SD) and the ratio of Tmsvl6-SD to R-R interval and the maximum time difference(Tmsvl6-Dif).STl parameters were the ratios of standard deviation of the time to peak longitudinal radial and circumferential strainat to R-R intervaI(Tls-16SD% Trs-16SD%，Tcs-16SD%) from the beginning of Q wave of electrocardiography to the point atminimal systolic Volume of all 16segments and the maximum time difference 。Results The LVEDVand LVESVof 3，6months after CRT were smaller than that before CRT,The LVEF raised . The Tmsv-16SD%、Tmsvl6Dif%、Tls-l6SD%、Trs-l6SD%、Tcs-l6SD% and T-Dif% of 3，6months after CRT reduced than that before CRT, (P<0.05). The Tmsv-16SD% 、Tmsvl6Dif%、Trs-l6SD%、Tcs-l6SD% were negatively associated with LVEF. Conclusion Real-time three-dimensionsl echocflrdiography and speckle tracking imaging represents a promising novel technique for assessment of global LV function and dyssynchr.

Key words: heart failure, echocardiography, doppler, color, cardiac resynchronization therapy, real-time three-dimensional echocardiography, speckle tracking imaging