实时三维超声心动图评价肥厚型心肌病患者左室收缩协调性研究

陈军红; 李东野; 王志荣; 徐通达; 张延斌

中国临床医学影像杂志 ›› 2014, Vol. 25 ›› Issue (7) : 466-468.

论著

实时三维超声心动图评价肥厚型心肌病患者左室收缩协调性研究

陈军红1，李东野2，王志荣1，徐通达1，张延斌1

作者信息 +

Study of real-time three-dimensional echocardiography in the assessment of left ventricular systolicsynchronization in patients with hypertrophic cardiomyopathy

CHEN Jun-hong1, LI Dong-ye2, WANG Zhi-rong1, XU Tong-da1, ZHANG Yan-bin1

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文章历史 +

摘要

目的：探讨实时三维超声心动图（RT3DE）评价肥厚型心肌病（HCM）患者左室心肌收缩协调性的临床价值。方法：40例左室射血分数正常的HCM患者和25例正常人，应用RT3DE方法分析其左室特定节段到达最小收缩容积时间（Tmsv）的标准偏差和最大差值被标准化为心动周期的百分比（Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%、Tmsv 6-Dif%）。结果：HCM患者的Tmsv 16-SD%、Tmsv 12-SD%、Tmsv 6-SD%、Tmsv 16-Dif%、Tmsv 12-Dif%、Tmsv 6-Dif%与对照组比较均显著延长（P<0.05），梗阻型与非梗阻型HCM相比无显著统计学差异（P>0.05）。与对照组比较，HCM患者RT3DE的左室各节段容积-时间曲线交错紊乱，同步性差。结论：HCM患者无论梗阻型或者非梗阻型均存在左室收缩协调性障碍，RT3DE技术能识别HCM患者早期左室收缩协调性异常，对于明确HCM患者心肌损害进程有重要意义。

Abstract

Objective: To assess left ventricular myocardial systolic dyssynchrony in patients with hypertrophic cardiomyopathy(HCM) by real-time three-dimensional echocardiography(RT3DE). Methods: Forty patients with HCM, 25 age and sex matched normal controls underwent examinations with 2D and full volume RT3DE. Ejection fraction was >0.55 in all subjects. According to with or without left ventricular outflow tract obstruction at rest, HCM patients were divided into 2 groups, non-obstructive HCM group and obstructive HCM group. With QLab 7.0 off-line software the 17 segmental volume-time curves were obtained. The difference(Dif) and standard deviation(SD) of the time to the point with minimal systolic volume(Tmsv) in 16, 12, and 6 segments were measured and adjusted by R-R interval(Tmsv Dif%, Tmsv SD%). Results: Compared with control group, the Tmsv 16-SD%, and there were no significant differences between non-obstructive and obstructive HCM group. The left ventricle volume-time curves of the HCM patients had disordered arrangement compared with the normal control. Conclusion: Systolic asynchrony is impaired in HCM patients with or without left ventricular outflow tract obstruction. The RT3DE is an useful method for detecting left ventricular dyssynchrony of HCM patients and provide additional value for understanding myocardial damage of HCM patients.

导出引用

陈军红;李东野;王志荣;徐通达;张延斌. 实时三维超声心动图评价肥厚型心肌病患者左室收缩协调性研究[J]. 中国临床医学影像杂志. 2014, 25(7): 466-468

CHEN Jun-hong;LI Dong-ye;WANG Zhi-rong;XU Tong-da;ZHANG Yan-bin. Study of real-time three-dimensional echocardiography in the assessment of left ventricular systolicsynchronization in patients with hypertrophic cardiomyopathy[J]. Journal of China Clinic Medical Imaging. 2014, 25(7): 466-468

中图分类号： Ｒ542.2 Ｒ540.45