CAJ | 학술논문

目的采用组织运动瓣环位移技术(TMAD)定量分析肥厚型心肌病(HCM)患者左室整体与节段纵向收缩功能及同步性,探讨其应用价值和可行性.方法连续选择非梗阻型肥厚型心肌病患者(nHCM)39例,同期选择性别、年龄相匹配的健康人39例作为对照组.采用二维斑点追踪技术(2D-STI)测量左室整体与节段纵向应变(LSR)以及采用QLAB8.1软件测量二尖瓣环6个位点(室间隔,侧壁,前间隔,后壁,前壁和下壁)二尖瓣环位移(MAD)以及达峰时间,计算二尖瓣环整体位移(MADglobal)以及左心室收缩期不同步化指数(SDI).分析LSR与MAD的相关性,比较两组MAD、SDI等参数.结果 TMAD有效跟踪节段数显著高于STI(98.7％对77.9％,P＜0.001).TMAD测量MAD与STI测量左室节段纵向应变(r=-0.784,P＜0.001)和整体应变(r=-0.897,P＜0.001)显著相关.与对照组比较,nHCM患者左室六个位点MAD以及MADglobal均显著减低(P均＜0.001),SDI显著增加(P＜0.001).结论 TMAD是评价nHCM患者左室纵向整体与节段收缩功能以及同步性的新方法.
목적 채용조직운동판배위이기술(TMAD)정량분석비후형심기병(HCM)환자좌실정체여절단종향수축공능급동보성,탐토기응용개치화가행성.방법 련속선택비경조형비후형심기병환자(nHCM)39례,동기선택성별、년령상필배적건강인39례작위대조조.채용이유반점추종기술(2D-STI)측량좌실정체여절단종향응변(LSR)이급채용QLAB8.1연건측량이첨판배6개위점(실간격,측벽,전간격,후벽,전벽화하벽)이첨판배위이(MAD)이급체봉시간,계산이첨판배정체위이(MADglobal)이급좌심실수축기불동보화지수(SDI).분석LSR여MAD적상관성,비교량조MAD、SDI등삼수.결과 TMAD유효근종절단수현저고우STI(98.7％대77.9％,P＜0.001).TMAD측량MAD여STI측량좌실절단종향응변(r=-0.784,P＜0.001)화정체응변(r=-0.897,P＜0.001)현저상관.여대조조비교,nHCM환자좌실륙개위점MAD이급MADglobal균현저감저(P균＜0.001),SDI현저증가(P＜0.001).결론 TMAD시평개nHCM환자좌실종향정체여절단수축공능이급동보성적신방법.
Objective To evaluate the value and feasibility of tissue mitral annular displacement (TMAD) in the assessment of left ventricular global and segmental longitudinal systolic function and synchronization in patients with hypertrophic cardiomyopathy.Methods The study population consisted of 39 on-obstructive hypertrophic cardiomyopathy (nHCM) patients and 39 healthy volunteers matched by gender and age.Left ventricular global and segmental longitudinal were measured by speckle tracking imaging(STI).The mitral annular displacement (MAD) (anterioseptal,posterioseptal,anterior,lateral,posterior and inferior sites,respectively),peak of time (PT) and left ventricular systolic dyssynchrony index (SDI) were measured by TMAD.The correlation between LSR and MAD was analyzed,and the parameters of MAD and SDI for tow groups were compared.Results The rate of effectively track segments of TMAD was significantly higher than that of STI(98.7％ vs 77.9％,P ＜0.001).There were high correlationship between segmental LSR and MAD(r =-0.784,P ＜0.001),and global and MADglobal (r =-0.897,P ＜0.001).Compared with the control group,MAD of six spots and MADglobal were significantly decreased (P ＜ 0.001,respectively),SDI was significantly increased(P ＜0.001).Conclusions TMAD is a sensitive and reproducible method for the assessment of LV longitudinal functionin patients with nHCM.