摘要
目的探讨定量组织速度显像(QTVI)技术评价充血性心力衰竭(CHF)患者左室收缩功能及判断心室非同步性的价值。方法选取左室射血分数(LVEF)≤40%、左室舒张末期内径(LVEDd)≥55 mm、NYHA心功能分级Ⅱ-Ⅳ级的CHF患者46例,对照组32例为体检健康人群,行M型超声心动图检查,测量LVEDd和收缩末期内径(LVED s),计算左室短轴缩短率(LVFS),S impson双平面法计算LVEF。心尖两腔观、长轴观、四腔观获取组织速度成像(TD I)图像,应用QTVI技术分析左室壁基底段及中间段共12个节段的心肌收缩达峰速度(Vs),自QRS起点测量每一取样点TVI曲线上收缩期达峰时间(Ts)、舒张早期达峰时间(Te),计算所有12节段Ts的标准差(Ts-SD)作为评价心室内同步性指标,任意两个节段Ts最大差值(△Ts-m ax)作为评价心室内收缩同步性指标,任意两个节段Te最大差值(△Te-m ax)作为评价心室舒张同步性指标。以Ts-SD>33 m s判定为心室内不同步,以△Ts-m ax>100 m s判定为心室内收缩不同步,以△Te-m ax>100 m s判定为心室内舒张不同步。结果CHF组LVEDd、LVFS、LVEF及左室心肌各节段Vs均低于对照组,差异有统计学意义(均P<0.01);CHF组心室内不同步、心室内收缩不同步、心室内舒张不同步发生率均高于对照组,分别为84.78%vs9.38%、91.30%vs6.25%和67.39%vs21.87%,差异均有统计学意义(P<0.05或P<0.01)。结论QTVI技术能快速、准确、无创地定量评价CHF患者左室收缩功能及判断心室非同步性。
Objective To assess with congestive heart failure（CHF） by the left ventricular myocardial contraction and asynchrony in patients quantitative tissue velocity imaging （QTVI）. Methods Forty-six patients with CHF and 32 healthy subjects were studied. Patients were in New York Heart Association （NYHA） class Ⅱ-Ⅳ heart failure,and had evidence of the left ventricular ejection fraction ≤40% ,and their left ventricular end-diastolic dimension （LVEDd） 〉155 mm. By M-mode echocardiography the LVEDd and left ventricular end-systolic dimension （LVEI）s） were measured, and the left ventricular fractional shortening（LVFS） was calculated. The left ventricular ejection fraction （LVEF） was measured with Simpson method. The peak velocity during systole （Vs） was evaluated on the 12 mid and basal ventricular segments at the apical two-chamber view, four-chamber view and long-axis view by QTVI. The time from beginning of the QRS complex to peak myocardial systolic contraction （Ts） and early diastolic relaxation （Te） were measured. The standard deviation of Ts of 12 left ventricular （LV） segments （Ts-SD） and the maximal difference in Ts （ATs-max） and Te （△Te-max） between any two of the LV segments were calculated. Ts-SD 〉 33 ms was used to define ventricular asynchrony and △Ts-max 〉 100 ms used to define systolic asynchrony and △Te-max 〉 100 ms used to define diastolic asynchrony. Results Compared with control group, the LVEDd, LVFS,LVEF and peak velocity during systole were significantly lower in CHF group （P 〈 0.01 ）. The incidence rate of ventricular asynchrony,systolie asynchrony and diastolic asynehrony were higher in CHF group than in control group [ 84.78% vs 9.38% （ P 〈 0.01 ） ,91.30% vs 6.25 % （ P 〈 0.01 ） and 67.39% vs 21.87 % （ P 〈 0.05 ）, respectively ]. Conclusion QTVI technology can be fast, non-invasive and quantitative for the evaluation of the left ventricular myocardium construction and asynchrony in patients with CH
出处
《现代医学》
2009年第2期92-95,共4页
Modern Medical Journal
