CAJ | 학술논문

目的应用二维斑点追踪显像(2D-STI)技术评价肥厚型梗阻性心肌病(HOCM)化学消融术前后患者左室收缩同步性,并探讨左室收缩同步性与左室流出道压差的关系.方法 21例HOCM患者于化学消融术前及术后6d,超声心动图测量左室流出道压差；获取左室短轴观(二尖瓣环、乳头肌和心尖水平)二维灰阶图像,应用2D-STI测量左室短轴观各节段收缩期径向应变达峰时间(TRS).计算左室整体径向应变达峰时间的标准差(TRS-SD).结果 21例HOCM患者左室流出道压差术后较术前明显下降,差异有统计学意义(P＜0.01).术后6d,前间隔基底段及中段径向TRS较术前明显延迟(P＜0.05),左室短轴观水平整体径向TRS-SD与术前比较差异无统计学意义(P＞0.05).前间隔基底段TRS延迟与左室流出道压差下降呈中等相关(r =0.657,P＜0.01).结论 2D-STI能准确检测HOCM患者化学消融术前后左室收缩同步性.
목적 응용이유반점추종현상(2D-STI)기술평개비후형경조성심기병(HOCM)화학소융술전후환자좌실수축동보성,병탐토좌실수축동보성여좌실류출도압차적관계.방법 21례HOCM환자우화학소융술전급술후6d,초성심동도측량좌실류출도압차；획취좌실단축관(이첨판배、유두기화심첨수평)이유회계도상,응용2D-STI측량좌실단축관각절단수축기경향응변체봉시간(TRS).계산좌실정체경향응변체봉시간적표준차(TRS-SD).결과 21례HOCM환자좌실류출도압차술후교술전명현하강,차이유통계학의의(P＜0.01).술후6d,전간격기저단급중단경향TRS교술전명현연지(P＜0.05),좌실단축관수평정체경향TRS-SD여술전비교차이무통계학의의(P＞0.05).전간격기저단TRS연지여좌실류출도압차하강정중등상관(r =0.657,P＜0.01).결론 2D-STI능준학검측HOCM환자화학소융술전후좌실수축동보성.
Objective To assess the characteristics of left ventrlcular ( LV) systolic syncnrony before and 6 days after percutaneous transluminal septal myocardial ablation (PTSMA) in patients with hypertrophic obstructive cardiomyopathy (HOCM) using two dimensional speckle tracking imaging(2DSTI),and to investigate correlation between the LV systolic synchrony and LV outflow-trace gradient (LVOTG).Methods LVOTG were measured before and 6 days after PTSMA in 21 patients with HOCM.The two dimensional loop-cinec were obtained in three levels of the short axis views of LV (mitral valve,papillary muscle and cardiac apex).The time from the onset of QRS complexes to systolic peak strain from the radial vectors (TRs) was recorded using 2D-STI.The standard deviation of the TRS of 18 segments (TRsSD) were calculated as indicator of LV systolic synchrony.Results Six days after PTSMA,LVOTG decreased significantly from (84.3 ± 19.1)mm Hg to (40.6 ± 8.3)mm Hg( P ＜0.01).TRS of the base and middle segments of anteroseptal were prolonged dramatically( P ＜0.05) 6 days after PTSMA compared with that before.There were no significantly differences in TRs-SD of LV between before and 6 days after PTSMA ( t =1.03,P ＞ 0.05).Decreased LVOTG correlated moderately to prolonged TRS of the base segments of anteroseptal ( r =0.657,P ＜0.05).Conclusions 2D-STI can detect exactly the characteristics of LV systolic synchrony before and 6 days after PTSMA in patients with HOCM.