二维应变成像在肥厚型心肌病患者右室局部和整体应变中的评价效果
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摘要
目的比较二维应变成像在肥厚型心肌病与高血压性左室肥厚患者中右心室部分与总体应变的评价效果。方法选取100例患者,其中41例高血压性左室肥厚患者为观察组,59例肥厚型心肌病患者为研究组。对比2组患者左心室舒张末期内径、左心室后壁厚度、右心室面积变化率、右心室基底段横径、三尖瓣环组织收缩峰值速度、三尖瓣环收缩期位移、右心室局部和整体纵向应变。结果研究组左心室舒张末期内径显著低于观察组(P<0.05),左心室后壁厚度显著高于观察组(P<0.05);2组右心室面积变化率、三尖瓣环收缩期位移均无显著差异(P>0.05);研究组右室基底段横径、三尖瓣环组织收缩峰值速度均显著低于观察组(P<0.05);研究组右心室部分与整体应变均值均显著高于观察组(P<0.05)。结论相比高血压性左室肥厚患者,二维应变成像应用于肥厚型心肌病患者更易表明其出现右室功能与结构重建的可能性。
Objective To compare the effect of two-dimensional strain imaging on evaluation of regional and global strain of right ventricle and hypertensive left ventricular hypertrophy in patients with hypertrophic cardiomyopathy.Methods A total of 100 cases were selected,in which 41 cases with hypertensive left ventricular hypertrophy were designed as observation group and 59 cases of hypertrophic cardiomyopathy were designed as study group.The left ventricular end diastolic diameter,left ventricular posterior wall thickness,right ventricular fractional area change,right ventricular basal dimension tracing,wall thickness of inter-ventricular septum,tricuspid annular plane systolic execution,right ventricular regional and global longitudinal strain by two-dimensional strain imaging were compared between the two groups.Results The left ventricular end diastolic diameter in the study group was significantly lower than the observation group(P<0.05),while the left ventricular posterior wall thickness was significantly higher than the observation group(P<0.05).The right ventricular fractional area change and tricuspid annular plane systolic excution showed no significant difference between the two groups(P>0.05).The right ventricular basal dimension tracing and wall thickness of inter-ventricular septum in the study group were significantly lower than the observation group(P<0.05).The regional and global strain in the study group were significantly higher than the observation group(P<0.05).Conclusion Compared with hypertensive left ventricular hypertrophy,the two-dimensional strain imaging is more helpful for indicating the presence of right ventricular function reconstructing in patients with hypertrophic cardiomyopathy.
Objective To compare the effect of two-dimensional strain imaging on evaluation of regional and global strain of right ventricle and hypertensive left ventricular hypertrophy in patients with hypertrophic cardiomyopathy.Methods A total of 100 cases were selected,in which 41 cases with hypertensive left ventricular hypertrophy were designed as observation group and 59 cases of hypertrophic cardiomyopathy were designed as study group.The left ventricular end diastolic diameter,left ventricular posterior wall thickness,right ventricular fractional area change,right ventricular basal dimension tracing,wall thickness of inter-ventricular septum,tricuspid annular plane systolic execution,right ventricular regional and global longitudinal strain by two-dimensional strain imaging were compared between the two groups.Results The left ventricular end diastolic diameter in the study group was significantly lower than the observation group(P<0.05),while the left ventricular posterior wall thickness was significantly higher than the observation group(P<0.05).The right ventricular fractional area change and tricuspid annular plane systolic excution showed no significant difference between the two groups(P>0.05).The right ventricular basal dimension tracing and wall thickness of inter-ventricular septum in the study group were significantly lower than the observation group(P<0.05).The regional and global strain in the study group were significantly higher than the observation group(P<0.05).Conclusion Compared with hypertensive left ventricular hypertrophy,the two-dimensional strain imaging is more helpful for indicating the presence of right ventricular function reconstructing in patients with hypertrophic cardiomyopathy.
引文
[1]齐欣.超声心动图检查在冠状动脉疾病中的应用(一)[J].中国心血管杂志,2015,20(6):420-423.
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[3]於晓平,杨杨,徐俊.斑点追踪技术在肥厚型心肌病患者的左心室心肌扭转运动中的评价作用[J].实用临床医药杂志,2013,17(19):14-16.
[4]Jalanko M,Tarkiainen M,Sipola P,et al.Left ventricular mechanical dispersion is associated with nonsustained ventricular tachycardia in hypertrophic cardiomyopathy[J].Ann Med,2016,48(6):417-427.
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[7]张隽,邓又斌,汤乔颖,等.二维斑点追踪技术评价肥厚型心肌病患者左心室各层心肌的收缩功能[J].中华超声影像学杂志,2015(4):277-281.
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[10]Voilliot D,Huttin O,Hammache N,et al.Impact of Global and Segmental Hypertrophy on Two-Dimensional Strain Derived from Three-Dimensional Echocardiography in Hypertrophic Cardiomyopathy:Comparison with Healthy Subjects[J].J Am Soc Echocardiogr,2015,28(9):1093-1102.
[11]尹丽,郭丽苹,薛炜.实时三维超声心动图评价肥厚型心肌病左室同步性的研究[J].中外健康文摘,2014,(12):102-103.
[12]Iio C,Inoue K,Nishimura K,et al.Characteristics of Left Atrial Deformation Parameters and Their Prognostic Impact in Patients with Pathological Left Ventricular Hypertrophy:Analysis by Speckle Tracking Echocardiography[J].Echocardiography,2015,32(12):1821-1830.
[13]Phelan D,Thavendiranathan P,Popovic Z,et al.Application of a parametric display of two-dimensional speckle-tracking longitudinal strain to improve the etiologic diagnosis of mild to moderate left ventricular hypertrophy[J].J Am Soc Echocardiogr,2014,27(8):888-895.
[14]赵蓓,李娟,朱伟红,等.实时三维超声评价肥厚型心肌病舒张失同步性及舒张功能[J].南方医科大学学报,2013,33(1):8-12.
[15]於晓平,杨杨,徐俊.斑点追踪技术在肥厚型心肌病患者的左心室心肌扭转运动中的评价作用[J].实用临床医药杂志,2013,17(19):14-16.
[16]徐刚,张笑春,曲小龙,等.心脏磁共振定量评价肥厚型心肌病患者的左室舒张功能[J].第三军医大学学报,2015,37(6):563-567.
[17]陈玲,金楠,李革.血管紧张素原基因M235T多态性与肥厚型心肌病关系的Meta分析[J].吉林大学学报:医学版,2014(1):132-136.
[18]陈景钗,汪荣华,欧阳元付.超声心动图检查对肥厚型心肌病的临床意义[J].中华全科医学,2014,12(5):794-795.
[2]Afonso L,Briasoulis A,Mahajan N,et al.Comparison of right ventricular contractile abnormalities in hypertrophic cardiomyopathy versus hypertensive heart disease using two dimensional strain imaging:a cross-sectional study[J].Int J Cardiovasc Imaging,2015,31(8):1503-1509.
[3]於晓平,杨杨,徐俊.斑点追踪技术在肥厚型心肌病患者的左心室心肌扭转运动中的评价作用[J].实用临床医药杂志,2013,17(19):14-16.
[4]Jalanko M,Tarkiainen M,Sipola P,et al.Left ventricular mechanical dispersion is associated with nonsustained ventricular tachycardia in hypertrophic cardiomyopathy[J].Ann Med,2016,48(6):417-427.
[5]Ozawa K,Funabashi N,Takaoka H,et al.Consistencies of3D TTE global longitudinal strain of both ventricles between assessors were worse for 2D,but better for 3D ventricular EF[J].Int J Cardiol,2015,198:140-151.
[6]颜玲玲,郝晶,宋宁,等.105例肥厚型心肌病患者心律失常特征分析[J].实用临床医药杂志,2014,18(11):155-156.
[7]张隽,邓又斌,汤乔颖,等.二维斑点追踪技术评价肥厚型心肌病患者左心室各层心肌的收缩功能[J].中华超声影像学杂志,2015(4):277-281.
[8]Prinz C,van Buuren F,Faber L,et al.Myocardial fibrosis is associated with biventricular dysfunction in patients with hypertrophic cardiomyopathy[J].Echocardiography,2012,29(4):438-444.
[9]Cincin A,Tigen K,Karaahmet T,et al.Right ventricular function in hypertrophic cardiomyopathy:A speckle tracking echocardiography study[J].Anatol J Cardiol,2015,15(7):536-541.
[10]Voilliot D,Huttin O,Hammache N,et al.Impact of Global and Segmental Hypertrophy on Two-Dimensional Strain Derived from Three-Dimensional Echocardiography in Hypertrophic Cardiomyopathy:Comparison with Healthy Subjects[J].J Am Soc Echocardiogr,2015,28(9):1093-1102.
[11]尹丽,郭丽苹,薛炜.实时三维超声心动图评价肥厚型心肌病左室同步性的研究[J].中外健康文摘,2014,(12):102-103.
[12]Iio C,Inoue K,Nishimura K,et al.Characteristics of Left Atrial Deformation Parameters and Their Prognostic Impact in Patients with Pathological Left Ventricular Hypertrophy:Analysis by Speckle Tracking Echocardiography[J].Echocardiography,2015,32(12):1821-1830.
[13]Phelan D,Thavendiranathan P,Popovic Z,et al.Application of a parametric display of two-dimensional speckle-tracking longitudinal strain to improve the etiologic diagnosis of mild to moderate left ventricular hypertrophy[J].J Am Soc Echocardiogr,2014,27(8):888-895.
[14]赵蓓,李娟,朱伟红,等.实时三维超声评价肥厚型心肌病舒张失同步性及舒张功能[J].南方医科大学学报,2013,33(1):8-12.
[15]於晓平,杨杨,徐俊.斑点追踪技术在肥厚型心肌病患者的左心室心肌扭转运动中的评价作用[J].实用临床医药杂志,2013,17(19):14-16.
[16]徐刚,张笑春,曲小龙,等.心脏磁共振定量评价肥厚型心肌病患者的左室舒张功能[J].第三军医大学学报,2015,37(6):563-567.
[17]陈玲,金楠,李革.血管紧张素原基因M235T多态性与肥厚型心肌病关系的Meta分析[J].吉林大学学报:医学版,2014(1):132-136.
[18]陈景钗,汪荣华,欧阳元付.超声心动图检查对肥厚型心肌病的临床意义[J].中华全科医学,2014,12(5):794-795.