CAJ | 학술논문

目的探讨超声斑点追踪二维应变(two-dimensional speckle tracking strain,2DS)技术在检测扩张型心肌病患者左室运动同步性中的临床价值.方法对37例扩张型心肌病患者行超声心动图检查,记录左室短轴观二尖瓣水平、乳头肌水平、心尖部图像及心尖四腔观、二腔观、左室长轴观高帧频图像,应用组织速度成像(TVI)技术测量纵向心肌收缩速度达峰值时间,同时应用2DS软件分别测量短轴及长轴上各节段径向及纵向应变达峰时间,定义前间隔、后壁对应节段达峰时间差值为左心室同步化指数(△T),以比较TVI与2DS在评价左室心肌运动同步性的应用价值.结果 2DS长轴基底段及2DS短轴基底段与TVI比较,△T值明显增大(P<0.01);2DS短轴中间段与TVI比较,△T明显增大(P<0.01).2DS短轴各节段△T与2DS长轴对应节段△T比较明显增大,且在基底段及中间段差异有统计学意义(P<0.05).2DS长轴各节段不同步例数及检出率均高于2DS短轴及TVI,且基底段差异具有统计学意义(P<0.01),2DS短轴各节段不同步例数及检出率与TVI比较差异无统计学意义.结论超声斑点追踪技术测量左室各节段纵向应变对左室运动不同步的检出率明显高于TVI法和超声斑点追踪左室短轴径向应变法.
목적 탐토초성반점추종이유응변(two-dimensional speckle tracking strain,2DS)기술재검측확장형심기병환자좌실운동동보성중적림상개치.방법 대37례확장형심기병환자행초성심동도검사,기록좌실단축관이첨판수평、유두기수평、심첨부도상급심첨사강관、이강관、좌실장축관고정빈도상,응용조직속도성상(TVI)기술측량종향심기수축속도체봉치시간,동시응용2DS연건분별측량단축급장축상각절단경향급종향응변체봉시간,정의전간격、후벽대응절단체봉시간차치위좌심실동보화지수(△T),이비교TVI여2DS재평개좌실심기운동동보성적응용개치.결과 2DS장축기저단급2DS단축기저단여TVI비교,△T치명현증대(P<0.01);2DS단축중간단여TVI비교,△T명현증대(P<0.01).2DS단축각절단△T여2DS장축대응절단△T비교명현증대,차재기저단급중간단차이유통계학의의(P<0.05).2DS장축각절단불동보례수급검출솔균고우2DS단축급TVI,차기저단차이구유통계학의의(P<0.01),2DS단축각절단불동보례수급검출솔여TVI비교차이무통계학의의.결론 초성반점추종기술측량좌실각절단종향응변대좌실운동불동보적검출솔명현고우TVI법화초성반점추종좌실단축경향응변법.
Objective To evaluate the dyssynchrony of left ventricle in patients with dilated cardiomyopathy by two-dimensional speckle-tracking strain (2DS) and tissue velocity imaging (TVI).Methods Study population consisted of 37 dilated cardiomyopathy patients. High frame rate two-dimensional images were recorded from the left ventricular short-axis views at the levels of mitral annulus,papillary muscles and apex, and the apical four-chamber view, two-chamber view and long-axis of the left ventricle. The time to peak myocardial longitudinal systolic velocity was measured by TVI, 2DS was acquired to measure the time to peak radial strain in the short axis and the time to peak longitudinal strain inthe long axis,left ventricular synchronization index (△T) was defined as the difference of the time to peak value between anterior septum and posterior wall. Results △T measured by 2DS on the long axis and the short axis increased significantly compared with TVI(P<0.01) in the basal segment; 2DS on the short axis had a more significantly increased △T than TVI(P<0.01) in the middle segment. △T measured by 2DS on the short axis significantly increased in the basal and middle segment compared with 2DS on the long axis(P<0.05). Dyssynchrony eases and the detection rate of dyssynchrony measured by 2DS on the long axis were significantly higher than 2DS on the short axis and TVI(P<0.01). Dyssynchrony cases and the detection rate measured by 2DS on the short axis were higher than those measured by TVI, but the difference had no statistical significance. Conclusions The dyssynchrony detection rate measured by longitudinal strain of 2DS is significantly higher than TVI and radial strain.