CAJ | 학술논문

目的应用三维斑点追踪成像(3D-STI)评价左室心肌致密化不全(LVNC)患者左室局部及整体收缩功能.方法双平面Simpson法测量左室射血分数≥50％ LVNC患者23例,与病例组匹配的健康人23例.病例组在二尖瓣、乳头肌、心尖三个水平按该节段是否受累分为非致密节段组及致密节段组,对照组三个水平按与病例组相对应的同水平同节段分为对照组1及对照组2.三维超声心动图采集心尖四腔观左室全容积数据并储存,3D-STI技术测量并比较左室整体圆周应变(GCS)、整体径向应变(GRS)、整体纵向应变(GLS)及左室各节段(16节段)圆周应变(rCS)、径向应变(rRS)、纵向应变(rLS).结果 ①病例组GCS、GRS、GLS均较对照组显著下降(P＜0.01);②心尖、乳头肌水平非致密节段组及致密节段组rCS、rRS、rLS均较同水平相对应对照组1及对照组2下降(P＜0.05);③心尖水平非致密节段与致密节段组间rRS、rLS差异具有统计学意义(P＜0.05).结论左室射血分数正常的LVNC患者早期收缩功能已受损,以心尖及乳头肌水平为主,且致密心肌节段、非致密心肌节段收缩功能均受损,心尖水平非致密心肌纵向及径向应变下降更明显.
목적 응용삼유반점추종성상(3D-STI)평개좌실심기치밀화불전(LVNC)환자좌실국부급정체수축공능.방법 쌍평면Simpson법측량좌실사혈분수≥50％ LVNC환자23례,여병례조필배적건강인23례.병례조재이첨판、유두기、심첨삼개수평안해절단시부수루분위비치밀절단조급치밀절단조,대조조삼개수평안여병례조상대응적동수평동절단분위대조조1급대조조2.삼유초성심동도채집심첨사강관좌실전용적수거병저존,3D-STI기술측량병비교좌실정체원주응변(GCS)、정체경향응변(GRS)、정체종향응변(GLS)급좌실각절단(16절단)원주응변(rCS)、경향응변(rRS)、종향응변(rLS).결과 ①병례조GCS、GRS、GLS균교대조조현저하강(P＜0.01);②심첨、유두기수평비치밀절단조급치밀절단조rCS、rRS、rLS균교동수평상대응대조조1급대조조2하강(P＜0.05);③심첨수평비치밀절단여치밀절단조간rRS、rLS차이구유통계학의의(P＜0.05).결론 좌실사혈분수정상적LVNC환자조기수축공능이수손,이심첨급유두기수평위주,차치밀심기절단、비치밀심기절단수축공능균수손,심첨수평비치밀심기종향급경향응변하강경명현.
Objective To evaluate regional and global systolic function of left ventricular using three-dimensional speckle tracking imaging (3D-STI) in patients with left ventricular non-compaction(LVNC).Methods Twenty-three patients with LVNC were included,all patients' left ventricular ejection fraction (LVEF) ≥50％ assessed by two-dimensional echocardiography,and twenty-three healthy subjects were enrolled in the study.The wall segments of the 23 patients with LVNC were divided into two groups:group of compacted segments and group of noncompacted segments.Corresponding to the two groups of LVNC patients according to one-by-one matching rule,all wall segments of 23 control subjects were divided into two paired groups (control group 2 and control group 1).The apical four-chamber view full-volume images of left ventricle were acquired by 3D-STI and were stored in dynamic mode.Global circumferential strain (GCS),global radial strain(GRS),global longitudinal strain(GLS) and segmental (16 segments) regional circumferential strain(rCS),regional radial strain(rRS),regional longitudinal strain(rLS) were recorded.Results ① Compared with the control group,GCS,GRS,GLS decreased significantly in the patients group (P ＜0.01).② Compared with control group 1 and group 2,rCS,rRS,rLS decreased in apical and the middle of noncompacted and compacted LV segments,the difference was significant (P ＜0.05),and no difference in basal segments(P ＞0.05).③ Compared with compacted segments,rRS,rLS in the noncompacted segments decreased significantly in apical.Conclusions Cardiac function of LVNC patients were already impaired mainly in apical and the middle segments when the values of LVEF was normal,Systolic function impaired both in noncompacted and compacted LV segments in apical and the middle,noncompacted and compacted LV segments in apical had comparable decreased rLS and rRS.