二维斑点追踪技术评价移植心脏左心室扭转

目的 探讨左室扭转评价移植心脏左心室功能的价值.方法 30例心脏移植受者,17例正常人,应用二维应变软件测量左室基底部和心尖部旋转角度、整体扭转角度及达峰时间,计算解旋率,比较两组间差异,并分析其与舒张末期、收缩末期容积及射血分数之间的关系.结果 移植组心尖部旋转角度及整体扭转角度均小于对照组.扭转角度与收缩末容积呈负相关,与射血分数呈正相关.两组间解旋率无明显差异.结论 二维斑点追踪技术可以准确反映左室扭转运动,为移植心脏左室收缩功能的整体判断提供重要的依据.

Evaluation of left ventricular torsion by two-dimensional ultrasound speckle tracking imaging in heart transplant patients

Objective To evaluate the value of left ventricular (LV) torsion for assessing left ventricular function in adult heart transplant patients using two-dimensional speckle tracking imaging.Methods Basal and apical LV short-axis view and apical LV long-axis view of two-demensional images were acquired in 30 heart transplant patients and 17 healthy volunteers. Using two-dimensional strain software,LV basal and apical rotation versus time profiles were obtained at their short-axis level respectively. LV torsion was defined as apical rotation relative to the base, so the LV torsion versus time profiles could be drawn. LV basal rotation,apical rotation,global torsion and their time to peak were respectively measured,and the rate of LV untwisting was calculated. Statistical analysis was used to find the difference between the two groups and to investigate the relationship between LV torsion or the rate of LV untwisting and echocardiographic parameters. Results LV apical rotation and LV global torsion in heart transplant group were significantly lower than those in normal group. LV global torsion inversely correlated with LV end systolic volume,positively with LV ejection fraction. There was no significant difference between the two groups in the rate of LV untwisting. The rate of LV untwisting didn't correlate with echocardiographic parameters. Conclusions LV torsion can be measured exactly by two-dimensional speckle tracking imaging, it can be used to quantify LV global systolic function in heart transplant patients.