摘要
目的应用速度向量成像技术评价风湿性二尖瓣狭窄患者及正常人左室心肌不同层面的旋转运动。方法选取心功能正常的风湿性二尖瓣狭窄患者38例，正常志愿者55例，采集胸骨旁左心室短轴心底部及心尖水平的二维超声图像，应用速度向量成像技术分别分析左室心底部及心尖部心肌收缩期旋转角度峰值及标化达峰时间、旋转速度峰值及标化达峰时间，比较二尖瓣狭窄患者与正常对照组间不同层面心肌旋转运动模式的差异，并评估二尖瓣狭窄程度对心肌旋转运动的影响。结果两组受检者心肌旋转方向相同。二尖瓣狭窄组心尖部各节段旋转角度、旋转速度较对照组明显降低（均P〈0．001），心底部部分节段（前壁、侧壁、后间隔）旋转速度较对照组降低（P〈0．05）。二尖瓣狭窄组心底与心尖标化角度达峰时间差值与正常对照组相比明显延长（P〈0．05）。不同程度的二尖瓣狭窄患者心底与心尖部旋转角度、标化角度达峰时间、旋转速度、标化速度达峰时间差异无统计学意义（P〉0．05）。结论左室射血分数正常的风湿性二尖瓣狭窄患者早期即有收缩功能的受损，且其损害程度与瓣膜狭窄严重程度无关。
Objective To assess the regional left ventricular （LV） rotation motion in the patients with rheumatic mitral stenosis （MS） with velocity vector imaging （VVI）. Methods This study included 38 patients with isolated MS （mild, moderate and severe） and 55 healthy control subjects. Short-axis parasternal views at the basal and apical level of LV were taken. Peak value of rotation angle and rotation velocity,as well as time to peak value were measured by VVI workplace offline respectively. Results①In the healthy control subjects LV rotates clockwisely at the base and counterclockwisely at the apex,the same as the patients with MS. ② In th patients with MS, rotaion angle and rotation velocity were significantly reduced at the apical level（ P〈0. 001）, rotation velocity were significantly reduced at some segments of basal level （anterior, lateral, septal） （ P〈0.05）. ③ Compared with the healthy control, the difference of time to peak roation angle between base and apex was significantly longer in patients with MS （ P〈0.05）. ④ There were no significant differences among mild, moderate and severe MS （ P〉0. 05）. Conclusions The patients with MS may suffer from systolic dysfunctin even in the early stage identified by the alteration of LV rotation motion, which is independent of the hemodynamic severity of MS.
出处
《中华超声影像学杂志》
CSCD
北大核心
2013年第7期568-571,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金（81000618）
江苏省属高校自然科学研究基金（10KJD320001）
关键词
超声心动描记术
风湿性心脏病
二尖瓣狭窄
心室功能
左
速度向量成像
Echocardiography
Rheumatic heart disease
Mitral valve stenosis
Ventricular function,left
Velocity vector imaging
