中华超声影像学杂志
中華超聲影像學雜誌
중화초성영상학잡지
CHINESE JOURNAL OF ULTRASONOGRAPHY
2014年
10期
829-834
,共6页
陈丽萍%魏薪%冯沅%陈茂%唐红
陳麗萍%魏薪%馮沅%陳茂%唐紅
진려평%위신%풍원%진무%당홍
超声心动描记术%主动脉瓣狭窄%心脏瓣膜假体植入%心室功能,左%三维斑点追踪显像
超聲心動描記術%主動脈瓣狹窄%心髒瓣膜假體植入%心室功能,左%三維斑點追蹤顯像
초성심동묘기술%주동맥판협착%심장판막가체식입%심실공능,좌%삼유반점추종현상
Echocardiography%Aortic valve stenosis%Heart valve prosthesis implantation%Ventricular function,left%Three-dimensional speckle tracking imaging
目的 应用三维斑点追踪显像(three-dimensional speckle tracking imaging,3D-STI)技术评估主动脉瓣狭窄(aortic stenosis,AS)患者经导管主动脉瓣植入(transcatheter aortic valve implantation,TAVI)术后左室整体及局部收缩功能变化.方法 20例在我院行TAVI术的重度AS患者,采集术前、术后7d及术后1月标准心尖四腔观三维图,运用TomTec脱机软件对左室纵向整体峰值应变(global longitudinal strain,GLS),左室纵向、径向、环向节段收缩期峰值应变等三维参数进行分析,比较不同时间点间上述指标的变化.结果 术后7d及术后1月主动脉瓣前向血流峰值血流速度(aortic valve blood flow velocity,AV)、平均跨瓣压差(mean aortic valve pressure gradient,mPAG)均较术前明显降低;术前三维左室射血分数(three-dimensional left ventricular ejection fraction,3D-LVEF)＜50％的患者,术后7 d 3D-LVEF改善明显,术前3D-LVEF＞50％的患者则变化不显著;术后1月不论3D-LVEF是否＜50％,3D-LVEF均有明显提高.术后7d左室GLS及各节段纵向峰值应变均有明显改善,术后1月改善更加明显.结论 TAVI术后早期左室收缩功能已有所改善.3D-STI为TAVI术后早期左室整体及节段心肌收缩功能评估提供了一种新型、简便的方法.
目的 應用三維斑點追蹤顯像(three-dimensional speckle tracking imaging,3D-STI)技術評估主動脈瓣狹窄(aortic stenosis,AS)患者經導管主動脈瓣植入(transcatheter aortic valve implantation,TAVI)術後左室整體及跼部收縮功能變化.方法 20例在我院行TAVI術的重度AS患者,採集術前、術後7d及術後1月標準心尖四腔觀三維圖,運用TomTec脫機軟件對左室縱嚮整體峰值應變(global longitudinal strain,GLS),左室縱嚮、徑嚮、環嚮節段收縮期峰值應變等三維參數進行分析,比較不同時間點間上述指標的變化.結果 術後7d及術後1月主動脈瓣前嚮血流峰值血流速度(aortic valve blood flow velocity,AV)、平均跨瓣壓差(mean aortic valve pressure gradient,mPAG)均較術前明顯降低;術前三維左室射血分數(three-dimensional left ventricular ejection fraction,3D-LVEF)＜50％的患者,術後7 d 3D-LVEF改善明顯,術前3D-LVEF＞50％的患者則變化不顯著;術後1月不論3D-LVEF是否＜50％,3D-LVEF均有明顯提高.術後7d左室GLS及各節段縱嚮峰值應變均有明顯改善,術後1月改善更加明顯.結論 TAVI術後早期左室收縮功能已有所改善.3D-STI為TAVI術後早期左室整體及節段心肌收縮功能評估提供瞭一種新型、簡便的方法.
목적 응용삼유반점추종현상(three-dimensional speckle tracking imaging,3D-STI)기술평고주동맥판협착(aortic stenosis,AS)환자경도관주동맥판식입(transcatheter aortic valve implantation,TAVI)술후좌실정체급국부수축공능변화.방법 20례재아원행TAVI술적중도AS환자,채집술전、술후7d급술후1월표준심첨사강관삼유도,운용TomTec탈궤연건대좌실종향정체봉치응변(global longitudinal strain,GLS),좌실종향、경향、배향절단수축기봉치응변등삼유삼수진행분석,비교불동시간점간상술지표적변화.결과 술후7d급술후1월주동맥판전향혈류봉치혈류속도(aortic valve blood flow velocity,AV)、평균과판압차(mean aortic valve pressure gradient,mPAG)균교술전명현강저;술전삼유좌실사혈분수(three-dimensional left ventricular ejection fraction,3D-LVEF)＜50％적환자,술후7 d 3D-LVEF개선명현,술전3D-LVEF＞50％적환자칙변화불현저;술후1월불론3D-LVEF시부＜50％,3D-LVEF균유명현제고.술후7d좌실GLS급각절단종향봉치응변균유명현개선,술후1월개선경가명현.결론 TAVI술후조기좌실수축공능이유소개선.3D-STI위TAVI술후조기좌실정체급절단심기수축공능평고제공료일충신형、간편적방법.
Objective To investigate the alternation of left ventricular systolic function in patients underwent transcatheter aortic valve implantation operation(TAVI) by three-dimensional speckle tracking technology (3D-STI).Methods Totally 20 patients with severe aortic stenosis were enrolled.All the subjects underwent successful TAVI operation.The real-time 3D full volume datasets on apical four-chamber view were acquired on before,7 days and 1 month after TAVI.Left ventricular global longitudinal strain(GLS),regional peak systolic longitudinal strain(LS),regional peak systolic circumferential strain(CS) and regional peak systolic radial strain(RS),were analysed using off-line TomTec software,the differences among the three groups were compared.Results Compared with the preoperation,aortic valve blood flow velocity (AV),mean aortic valve pressure gradient(mPAG) of 7 days after operation decreased significantly.Threedimensional left ventricular ejecation fraction(3D-LVEF) among the patients whose 3D-LVEF under 50％had a remarkable increase and whose 3D-LVEF exceed 50％ before operation had no significant change,while 1 month after operation the 3D-LVEF had a significant improvement compared with the preoperational data regardless of 3D-LVEF under 50％ or not.The GLS and LS of all segments of 7 days after TAVI were higher than pre-operation(all P ＜0.05),and it had a further improvement 1 month after TAVI.Conclusions LV systolic function had improvement early after TAVI.3D-STI is a new,convenient way to detect the global and regional left ventricular systolic function of TAVI patients.
