超声斑点追踪技术与多普勒组织速度显像评价心肌梗死患者左心室内不同步性

目的 评价超声斑点追踪技术在定量心肌梗死患者左心室内不同步性的价值.方法 采集30例心肌梗死患者左心室短轴切面(二尖瓣,乳头肌,心尖部)和心尖位四腔切面、二腔切面和左心室长轴的二维灰阶与组织多普勒(TVI)动态图,应用二维应变软件分别测量左心室短轴与左心长轴的各节段的径向与纵向应变收缩期达峰时间;同时用组织多普勒技术测量左心长轴的各节段的组织速度的收缩期达峰时间.如左心长轴每一节段6个壁的收缩期最早与最晚达峰时间的差值>110 ms、左心室短轴每一节段前间隔与后壁的达峰时间差值>130 ms即为左心室内收缩不同步.结果 基底部左心室短轴径向应变达峰时间明显长于组织多普勒纵向收缩期速度达峰时间(P<0.01);心尖部左心室短轴径向应变达峰时间明显长于左心室纵向应变达峰时间(P<0.01).二维应变短轴检出率高于二维应变长轴,两者均高于组织多普勒长轴.结论 超声斑点追踪技术可以较好地评价左心室内不同步性,二维应变短轴可更准确地判断心肌梗死患者心尖段的不同步性.

Evaluation of left ventricular systolic asynchrony in patients with myocardial infarction: speckle tracking echocardiography vs tissue Doppler velocity imaging

Objective To assess the feasibility of speckle tracking two-dimensional strain(2-DS)echoeardiographic assess- ment of left ventrieular systolic asynchrony in patients with myocardial infarction.Methods Thirty patients with myocardial infarction underwent tissue velocity imaging(TVI)and 2-DS examination.The maximal differences in time to peak myocar- dial systolic velocity(Ts)were measured and calculated in 6 basal segments and 6 middle ones by TVI from apical four- chamber,two-chamber and long-axis view of the left ventricle respectively,while in Ts were measured and calculated in 6 basal segments,6 middle ones and 6 apical ones by 2-DS long axis view and short-axis view.Results The Ts measured with short-axis radial strain in basal segments was significantly longer than that measured with TVI long-axis,and measured with short-axis radial strain in apex was significantly longer than that measured with long-axis longitudinal strain.The number of segments with asynchrony detected by 2 DS was larger than that by TVI long-axis.Meanwhile,the number of segments with asynchrony detected by short-axis radial strain was larger than that by long-axis longitudinal strain.Conclusion Speck- le tracking echocardiography can accurately quantify left ventricular systolic asynchrony in patients with myocardial infarc- tion.