CAJ | 학술논문

目的应用超声斑点追踪成像技术(STI)定量研究心内膜弹力纤维增生症(EFE)患儿左心室短轴各节段心肌的二维应变,探讨其变化规律.资料与方法23例 EFE 患儿取胸骨旁左心室短轴基底段、中间段和心尖段连续5个心动周期图像(3个平面显示左心室16节段).应用 QLab 8.1软件分析各短轴平面的整体应变峰值和各节段收缩期应变峰值.选择20例性别、年龄相匹配的健康体检者作为对照组.结果① EFE 组心内膜增厚的部位集中在下壁(100%)、后壁(100%)、侧壁(87%),少数累及前壁(4%);②与对照组比较,EFE 组左心室所有节段圆周应变峰值降低(P<0.01),11节段径向应变减低(P<0.05、P<0.01);EFE 组左心室短轴 3个平面整体应变明显降低(P<0.01);③ EFE 组内各平面下、后、侧壁心肌较其余各壁径向及圆周应变减低程度无显著差异.结论 EFE 患儿心内膜增厚呈非均匀性,EFE 患儿左心室短轴整体及各节段收缩期圆周应变和多数节段的径向应变明显低于正常人,提示其左心室短轴收缩功能严重受损,且心肌的收缩功能呈非均匀弥漫性减低.
목적응용초성반점추종성상기술(STI)정량연구심내막탄력섬유증생증(EFE)환인좌심실단축각절단심기적이유응변,탐토기변화규률.자료여방법23례 EFE 환인취흉골방좌심실단축기저단、중간단화심첨단련속5개심동주기도상(3개평면현시좌심실16절단).응용 QLab 8.1연건분석각단축평면적정체응변봉치화각절단수축기응변봉치.선택20례성별、년령상필배적건강체검자작위대조조.결과① EFE 조심내막증후적부위집중재하벽(100%)、후벽(100%)、측벽(87%),소수루급전벽(4%);②여대조조비교,EFE 조좌심실소유절단원주응변봉치강저(P<0.01),11절단경향응변감저(P<0.05、P<0.01);EFE 조좌심실단축 3개평면정체응변명현강저(P<0.01);③ EFE 조내각평면하、후、측벽심기교기여각벽경향급원주응변감저정도무현저차이.결론 EFE 환인심내막증후정비균균성,EFE 환인좌심실단축정체급각절단수축기원주응변화다수절단적경향응변명현저우정상인,제시기좌심실단축수축공능엄중수손,차심기적수축공능정비균균미만성감저.
Purpose To quantify two-dimensional systolic strain of short axis in left ventricle (LV) in patients with endocardial fibroelastosis (EFE) using speckle tracking imaging (STI). Materials and Methods Echocardiographic examinations were performed on 23 patients with EFE and 20 healthy subjects were recruited as controls. LV short-axis views of five consecutive cardiac cycles were obtained. QLab 8.1 was used to analyze global strains in basal, middle, and apical views, as well as systolic peak radial and circumferential strains in LV 16 segments. Results① Thickened endocardium of EFE mostly involved the inferior wall (100%), posterior wall (100%) and lateral wall (87%), with little chance to involve anterior wall (4%). ②Compared with the controls, peak of all segments of LV circumferential strain (P<0.01) and systolic peak radial strain in 11 of 16 segments (P<0.05, P<0.01) significantly reduced in EFE group. Overall strain in all three planes of short axis of LV also significantly reduced (P<0.01). ③ There was no significant difference of systolic peak radial and circumferential strains between the inferior, posterior and lateral segments and other segments in the same view. Conclusion Endocardial thickening of EFE children is non-uniformly where LV global strain, systolic peak circumferential strain in all segments and systolic peak radical strain in 11 of 16 segments significantly reduced in EFE children when compared with normal children, which indicates systolic function of LV short-axis in EFE children is severely impaired with non-uniformly diffuse reduction.