天津医药

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二维斑点追踪技术对急性心肌梗死左室扭转与解旋运动的研究

王君1,周长钰1,郑成环2,富华颖1,索娅3   

  1. 1. 天津医科大学第二医院心脏科
    2. 医大二院
    3. 00
  • 收稿日期:2009-12-10 修回日期:2010-03-04 出版日期:2010-05-15 发布日期:2010-05-15
  • 通讯作者: 王君

The Assessment of left ventricular twist and untwist in patients with acute infarcted myocardial by two-dimensional speckle tracking

  • Received:2009-12-10 Revised:2010-03-04 Published:2010-05-15 Online:2010-05-15

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摘要： 摘要 目的：应用二维超声斑点追踪显像（STI）技术探讨急性心肌梗死患者左心室扭转(LVtw)及解旋运动的特征。方法：入选60例急性心肌梗死患者及30例正常对照者，心肌梗死患者根据左室收缩功能分为:左室射血分数 (LVEF)正常组 (LVEF≥50% ,36例 )和 LVEF减低组 (LVEF < 50% , 24例 )。取胸骨旁左室心尖和心底短轴观二维图像，应用二维应变软件测量左室各个节段旋转角度，同步记录左室扭转峰值(Ptw) 及其达峰时间、心尖旋转峰值 (PAR) 及其达峰时间、心底旋转峰值 (PBR) 及其达峰时间、收缩末期左心室扭转角度 (AVCtw)、等容舒张期末扭转角度 (MVOtw) 、解旋率 (Untw R) 、解旋减半时间 ( HTU )。结果：(1)与对照组相比，AMI患者LVEF减低组Ptw、 PAR、PBR、AVCtw、MVOtw均明显减低（P＜0.05）。AMI患者LVEF正常组与对照组相比，Ptw、 PAR、AVCtw、MVOtw均减低（P＜0.05）。（2）AMI患者LVEF减低组与AMI患者LVEF正常组相比，Ptw、AVCtw、MVOtw减低（P＜0.05）。（3）采用Simpson’s 法测量的EF值与Ptw值显著相关(r=0.527，P<0.05)。结论：应用 STI可定量评价AMI患者左心室扭转及解旋运动，心肌梗死患者心尖部旋转角度及整体水平扭转角度明显减低 , 左室扭转可作为评价左室收缩功能的定量指标。

关键词: 超声心动描记术, 二维斑点追踪显像, 急性心肌梗死, 扭转, 解旋

Abstract: Abstract Objective: To assess the left ventricular twist and untwist in patients with acute infarcted myocardial ( AMI ) by two-dimensional speckle tracking imaging ( STI) .Method: Two-dimensional images of left ventricule (LV) at basal and apical short-axis views were acquired in 60 patients with AMI and 30 healthy subjects to evaluate LV rotation1．Patients with AMI were divided into two groups according to global LV systolic function: normal LV ejection fraction (LVEF) group, (LVEF≥50% , n=36) and abnormal LVEF gruop (LVEF <50% , n = 24 ) .Rotation were measured in the left ventricular short-axis views using 2D-strain software. LV twist were defined as rate of apical LV rotation (PAR)to the basal Peak rotation (PBR) and the time to Prot in basal and apical short axis views were measured separately, Peak twist(Ptw), twist at aortic valve closure(AVCtw), twist at mitral valve opening (MVO tw), untwisting rate(Untw R), and half time of untwisting (HTU )were calculated. Results: Compared with the control group , the value of Ptw、PAR、PBR、AVCtw and MVOtw significantly decreased in abnormal LVEF group；the value of Ptw、PAR、AVCtw and MVOtw decreased in normal LVEF group . Compared with normal LVEF group ,the value of Ptw、AVCtw and MVOtw significantly decreased in abnormal LVEF group.Significant correlation was found between LV twist and LVEF. Conclusion: Left ventricular twist and untwist can be measured using speckle tracking echocardiography. Apical rotation and global twist decrease significantly in patients with myocardial infarction.

Key words: Echocardiography , Speckle tracking imaging, Acute infarcted myocardial , Twist, untwist