CAJ | 학술논문

目的应用二维斑点追踪技术(2D-STI)定量评价缺血性心肌病(ICM)和扩张型心肌病(DCM)患者左心房功能.方法选择ICM患者22例、DCM患者26例和健康对照者32例,采用双平面法测量左房最大容积(LAVmax)、最小容积(LAVmin)、收缩前容积(LAVp),并计算左房总的排空容积(LATV)、膨胀指数(AEI)、主动排空容积(LAEV)、主动射血分数(LAEF).运用2D-STI测量左房房间隔、侧壁、前壁、下壁的收缩期应变(Ss)、应变率(SRs),舒张晚期应变(Sa)、应变率(SRa).计算出所有房壁的平均应变及应变率,并分析左房功能指标与应变率之间的相关性.结果 ①三组受检者的年龄、性别、心率、E峰等指标差异无统计学意义.ICM组和DCM组A峰、E峰减速时间(DT)、左室射血分数(LVEF)较对照组减小,左房前后径(LAD)、左室舒张末期内径(LVEDD)、E/A则增大(P＜0.05),ICM组和DCM组之间差异无统计学意义.②与对照组相比,ICM组和DCM组LAVmax显著增大,而AEI、LAEF则降低,差异有统计学意义(P＜0.05)；与ICM组相比,DCM组AEI、LAEF更低(P＜0.05).③与对照组相比,ICM组和DCM组Ss、SRs、Sa和SRa均降低(P＜0.05),且DCM组降低更显著(P＜0.05).④AEI与SRs呈较好的正相关(r=0.765,P＜0.01)；LAEF与SRa具有较强的相关性(r=0.830,P＜O.01).结论 ICM和DCM患者收缩期左房储血功能和舒张晚期主动射血功能均降低,且DCM患者较ICM患者降低更明显.2D-STI技术能较好地评价左房功能.
목적 응용이유반점추종기술(2D-STI)정량평개결혈성심기병(ICM)화확장형심기병(DCM)환자좌심방공능.방법 선택ICM환자22례、DCM환자26례화건강대조자32례,채용쌍평면법측량좌방최대용적(LAVmax)、최소용적(LAVmin)、수축전용적(LAVp),병계산좌방총적배공용적(LATV)、팽창지수(AEI)、주동배공용적(LAEV)、주동사혈분수(LAEF).운용2D-STI측량좌방방간격、측벽、전벽、하벽적수축기응변(Ss)、응변솔(SRs),서장만기응변(Sa)、응변솔(SRa).계산출소유방벽적평균응변급응변솔,병분석좌방공능지표여응변솔지간적상관성.결과 ①삼조수검자적년령、성별、심솔、E봉등지표차이무통계학의의.ICM조화DCM조A봉、E봉감속시간(DT)、좌실사혈분수(LVEF)교대조조감소,좌방전후경(LAD)、좌실서장말기내경(LVEDD)、E/A칙증대(P＜0.05),ICM조화DCM조지간차이무통계학의의.②여대조조상비,ICM조화DCM조LAVmax현저증대,이AEI、LAEF칙강저,차이유통계학의의(P＜0.05)；여ICM조상비,DCM조AEI、LAEF경저(P＜0.05).③여대조조상비,ICM조화DCM조Ss、SRs、Sa화SRa균강저(P＜0.05),차DCM조강저경현저(P＜0.05).④AEI여SRs정교호적정상관(r=0.765,P＜0.01)；LAEF여SRa구유교강적상관성(r=0.830,P＜O.01).결론 ICM화DCM환자수축기좌방저혈공능화서장만기주동사혈공능균강저,차DCM환자교ICM환자강저경명현.2D-STI기술능교호지평개좌방공능.
Objective To evaluate left atrial function in patients with ischemic cardiomyopathy(ICM)and dilated cardiomyopathy(DCM)by two dimensional-speckle tracking imaging(2D-STI).Methods Twenty-two patients with ICM,twenty-six with DCM and thirty-two healthy subjects were studied.The maximum volume(LAVmax),minimum volume(LAVmin)and volume before the systole(LAVp)of left atria were acquired using biplane area-length method,and calculated the total emptying volume(LATV),expansion index(AEI),active emptying volume(LAEV)and fraction(LAEF)of left atria.The strain and strain rate during systole and late of diastole(Ss,SRs,Sa and SRa)were measured at each left atrial wall (septal,lateral,anterior and inferior).The average of them were worked out.The correlation of left atrial function and strain rate were analysed.Results ①No significant differences were found at the age,sex,heart rate and the E wave between the mitral leaflet tips during all the groups.Compared with the control group,the peak of A wave,the deceleration time of E wave and LVEF decreased in ICM and DCM groups,while the LAD,LVEDD and E/A increased significantly in the two groups(P＜0.05).There were no significant differences between ICM and DCM.②Compared with the controls,the LAVmax increased,AEI and LAEF decreased significantly in patients with ICM and DCM,even lower in DCM(p＜0.05).③Compared with the controls,the Ss,SRs,Sa and SRa reduced significantly in patients with ICM and DCM(P＜0.05),and the DCM showed much significant differences than ICM(P＜0.05).④The AEI had a positive correlation with SRs(r =0.765,P＜0.01).The LAEF had a significant correlation with SRa(r =0.830,P＜0.01).Conclusions The accumulation during systole and active emptying function during late of diastole are both lower in ICM and DCM,even worse in the latter.The 2D-STI may paly an important role in the evaluation of left atrial function.