CAJ | 학술논문

目的应用二维斑点追踪技术探讨致左心容量负荷增加的常见左向右分流先天性心脏病(CHD)对左室旋转及扭转运动的价值.方法收集室间隔缺损(20例)及动脉导管未闭患者(16例)为CHD组,年龄、性别相匹配的正常人36例为对照组,常规二维超声下测量常规心脏超声参数,Simpson双平面法测出左室舒张末期容积(LVEDV)及收缩末期容积(LVESV),计算左室射血分数(LVEF),记录并采集左室心尖部及基底部短轴观三个完整心动周期的二维图像,应用二维应变分析软件对CDH组及对照组左室旋转及扭转运动进行分析,测量并记录左室旋转及扭转运动参数,比较各组参数间是否具有统计学意义,并进一步探讨左室旋转及扭转运动参数与左室容量负荷参数间是否有相关性.结果与正常对照组相比,CHD组左室扭转角度峰值及心尖部旋转角度均明显增大,差异有统计学意义(P＜0.05).左室扭转角度峰值与LVEDV及LVESV有相关性.结论常见左向右分流CHD所导致的左心容量负荷增加对左室扭转运动及心尖部旋转运动有影响,对左室基底部旋转运动影响不明显,并且左室扭转运动与LVEDV和LVESV有相关性.
목적 응용이유반점추종기술탐토치좌심용량부하증가적상견좌향우분류선천성심장병(CHD)대좌실선전급뉴전운동적개치.방법 수집실간격결손(20례)급동맥도관미폐환자(16례)위CHD조,년령、성별상필배적정상인36례위대조조,상규이유초성하측량상규심장초성삼수,Simpson쌍평면법측출좌실서장말기용적(LVEDV)급수축말기용적(LVESV),계산좌실사혈분수(LVEF),기록병채집좌실심첨부급기저부단축관삼개완정심동주기적이유도상,응용이유응변분석연건대CDH조급대조조좌실선전급뉴전운동진행분석,측량병기록좌실선전급뉴전운동삼수,비교각조삼수간시부구유통계학의의,병진일보탐토좌실선전급뉴전운동삼수여좌실용량부하삼수간시부유상관성.결과 여정상대조조상비,CHD조좌실뉴전각도봉치급심첨부선전각도균명현증대,차이유통계학의의(P＜0.05).좌실뉴전각도봉치여LVEDV급LVESV유상관성.결론 상견좌향우분류CHD소도치적좌심용량부하증가대좌실뉴전운동급심첨부선전운동유영향,대좌실기저부선전운동영향불명현,병차좌실뉴전운동여LVEDV화LVESV유상관성.
Objective To assess the value of left ventricular (LV) twist and rotation in left-to-right shunt congenital heart diseases(CHD) by two-dimensional speckle tracking imaging(2D-STI).Methods 16 patent ductus arteriosus(PDA),20 ventricular septal defect(VSD) and 36 age,sex matched normal subjects were included.LV end-diastolic volume (LVEDV) and LV end-systolic volume (LVESV) were measured by Biplane Simpson method,then LV ejection fraction (LVEF) was calculated.Two-dimensional images in LV basal and apical short-axis views in three complete cardiac cycles were required.Using speckle tracking imaging,the rotation of 6 segments in basal and apical short-axis levels were measured in CHD patients and control subjects,respectively.Basal and apical rotation versus time profiles and LV twist versus time profiles were drawn.Correlation analysis of LVEDV,LVESV and LV peak twist and rotation were made respectively.Results Compared to the control group,LV peak twist and the apical rotation were increased in CDH patients,which was statistically significant (P ＜0.05).LV peak twist had significant correlation with LVEDV and LVESV.Conclusions LV volume overload which was caused by left-to-right shunt CHD significantly impacted LV twist and apical rotation,but has no significant effect in basal rotation.LV peak twist correlated with LVEDV and LVESV.