CAJ | 학술논문

目的:探讨三维斑点追踪技术(3D-STI)评价慢性心力衰竭(CHF)心脏再同步化治疗(CRT)疗效的可靠参数. 方法:CHF患者36例,CRT治疗前及治疗后1周、1个月和3个月行3D-STI检查,测量左心室16节段径向应变、环向应变以及面积应变的达峰时间标准差(AT-SD)、达峰时间最大差值(AT-Dif)和左心室收缩末期容积(LVESV)及射血分数(3D-LVEF),计算3个月后LVEF、AT-SD和AT-Dif的改变量. 选择40例正常人作为对照组. 结果:有效组和无效组术前径向应变、环向应变和面积应变的AT-SD、 AT-Dif及LVESV均大于对照组(P < 0.05). 有效组术前 3 种应变的 AT-SD、AT-Dif 均大于无效组(P < 0.05);而 LVESV 和3D-LVEF两组间无统计学差异 (P > 0.05). 有效组术后1周3种应变的AT-SD、AT-Dif较术前均明显减小(P < 0.05),而术后1 周后无明显变化. 无效组术后3 种应变的AT-SD、AT-Dif及 LVESV、3D-LVEF 无明显改变(P > 0.05). 径向应变、环向应变以及面积应变AT-SD、AT-Dif的改变量(AT-SD, AT-SD)与 LVEF呈负相关. 结论: 3D-STI技术可以较好地评价CRT的短期疗效;面积应变是预测、评价CRT疗效的可靠指标.
목적:탐토삼유반점추종기술(3D-STI)평개만성심력쇠갈(CHF)심장재동보화치료(CRT)료효적가고삼수. 방법:CHF환자36례,CRT치료전급치료후1주、1개월화3개월행3D-STI검사,측량좌심실16절단경향응변、배향응변이급면적응변적체봉시간표준차(AT-SD)、체봉시간최대차치(AT-Dif)화좌심실수축말기용적(LVESV)급사혈분수(3D-LVEF),계산3개월후LVEF、AT-SD화AT-Dif적개변량. 선택40례정상인작위대조조. 결과:유효조화무효조술전경향응변、배향응변화면적응변적AT-SD、 AT-Dif급LVESV균대우대조조(P < 0.05). 유효조술전 3 충응변적 AT-SD、AT-Dif 균대우무효조(P < 0.05);이 LVESV 화3D-LVEF량조간무통계학차이 (P > 0.05). 유효조술후1주3충응변적AT-SD、AT-Dif교술전균명현감소(P < 0.05),이술후1 주후무명현변화. 무효조술후3 충응변적AT-SD、AT-Dif급 LVESV、3D-LVEF 무명현개변(P > 0.05). 경향응변、배향응변이급면적응변AT-SD、AT-Dif적개변량(AT-SD, AT-SD)여 LVEF정부상관. 결론: 3D-STI기술가이교호지평개CRT적단기료효;면적응변시예측、평개CRT료효적가고지표.
Objective To investigate the reliable parameters of the efficacy of CRT on patients with CHF evaluated by 3D-STI. Methods Thirty-six patients with CHF were performed by three-dimensional speckle tracking imaging (3D-STI) before and at one week, one month and three months after CRT, respectively. The left ventricular end systolic volume (3D-LVESV), the left ventricular ejection fraction (3D-LVEF) and the left ventricular dys-synchrony parameters which include the standard deviation of time to peak (AT-SD) and the maximum difference of time to peak (AT-Dif) of radial strain, circumferential strain and area tracking in the 16 left ventricular segments and the changes of 3D-LVESV, 3D-LVEF (ΔLVEF), AT-SD (ΔAT-SD) and AT-Dif (ΔAT-Dif) at 3 months after CRT were determined. Forty normal volunteers as the controls were performed 3D-STI only once. Results AT-SD, AT-Dif of three kinds of strain, LVESV of the patients in both effective and non-effective groups were significantly higher than those in the control group before CRT (P < 0.05). AT-SD, AT-Dif of three kinds of strain in the CRT effective group were significantly higher than those in the CRT non-effective group , whereas 3D-LVESV and 3D-LVEF were not significantly different between these two groups before CRT. For the CRT effective group, one week after CRT, all of the left ventricular dyssynchrony parameters were decreased (P < 0.05, respectively). For the CRT non-effective group, the changes of total assessment parameters after CRT were not significant (P > 0.05). ΔAT-SD and ΔAT-Dif were negatively correlated with ΔLVEF. Conclusion 3D-STI can efficiently evaluate the short-term efficacy of CRT , and the area tracking is a reliable parameter to predict and assess CRT efficacy.