二维斑点追踪成像技术评价主动脉瓣二叶畸形患者心动周期不同时相左室旋转与扭转功能
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摘要
目的探讨二维斑点追踪成像(2D-STI)技术评价主动脉瓣二叶畸形(BAV)患者在心动周期不同时相的左室旋转与扭转功能。方法选取BAV患者44例、三叶式主动脉瓣(TAV)病变患者26例和健康对照组40例。应用2D-STI技术获得左室基底和心尖水平等容收缩期、射血期、等容舒张期、充盈期及心房收缩期的旋转角度峰值(IVC-rot、VE-rot、IVR-rot、VF-rot、AS-rot),并计算各时相左室扭转角度峰值(IVC-twi、VE-twi、IVR-twi、VF-twi、AS-twi)。结果与对照组比较,TAV组、BAV组左室基底水平VE-rot、VF-rot降低,AS-rot升高;心尖水平AS-rot降低,VE-rot在TAV组升高、BAV组降低(均P<0.05);TAV组、BAV组IVC-twi升高,VF-twi、AS-twi降低,VE-twi在TAV组升高,BAV组降低(均P<0.05)。与TAV组比较,BAV组左室心尖水平VE-rot及VE-twi、VF-twi降低,IVC-twi升高(均P<0.05)。结论 2D-STI技术可发现BAV患者心动周期不同时相的左室旋转与扭转功能变化。
Objective To evaluate the left ventricular rotation and twist function of patients with bicuspid aortic valve(BAV)at different phrases of cardiac cycle by 2-dimensional speckle tracking imaging(2D-STI).Methods 44 patients with BAV,26 patients with trilobular aortic valve(TAV)and 40 volunteers were selected.The bulk-rotation curve of the left ventricle was obtained by 2D-STI.We obtain the peak values of rotation angle of isovolumic contraction,ejection,isovolumetric relaxation,filling,and atrial systolic period(IVC-rot,VE-rot,IVR-rot,VF-rot,ASrot),and calculate peak values of the different twist angle at each of the above periods(IVC-twi,VE-twi,IVR-twi,VF-twi,AS-twi).Results Compared with the control group,the basal level VE-rot and VF-rot of the TAV and BAV group were decreased,AS-rot was increased,the apex level AS-rot was decreased,and VE-rot was increased in the TAV group and the BAV group(all P<0.05).In the peak value of torsion angle,IVC-twi was increased,VF-twi and AS-twi were decreased,and VE-twi was increased in the TAV and BAV group(all P<0.05).Compared with the TAV group,the apex level VE-rot,VE-twi,VF-twi and IVC-twi were decreased and IVC-twi was increased in the BAV group(all P<0.05).Conclusions 2D-STI technique can be used to detect the changes of left ventricular rotational and twist function in different phases of cardiac cycle in BAV patients.
Objective To evaluate the left ventricular rotation and twist function of patients with bicuspid aortic valve(BAV)at different phrases of cardiac cycle by 2-dimensional speckle tracking imaging(2D-STI).Methods 44 patients with BAV,26 patients with trilobular aortic valve(TAV)and 40 volunteers were selected.The bulk-rotation curve of the left ventricle was obtained by 2D-STI.We obtain the peak values of rotation angle of isovolumic contraction,ejection,isovolumetric relaxation,filling,and atrial systolic period(IVC-rot,VE-rot,IVR-rot,VF-rot,ASrot),and calculate peak values of the different twist angle at each of the above periods(IVC-twi,VE-twi,IVR-twi,VF-twi,AS-twi).Results Compared with the control group,the basal level VE-rot and VF-rot of the TAV and BAV group were decreased,AS-rot was increased,the apex level AS-rot was decreased,and VE-rot was increased in the TAV group and the BAV group(all P<0.05).In the peak value of torsion angle,IVC-twi was increased,VF-twi and AS-twi were decreased,and VE-twi was increased in the TAV and BAV group(all P<0.05).Compared with the TAV group,the apex level VE-rot,VE-twi,VF-twi and IVC-twi were decreased and IVC-twi was increased in the BAV group(all P<0.05).Conclusions 2D-STI technique can be used to detect the changes of left ventricular rotational and twist function in different phases of cardiac cycle in BAV patients.
引文
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[12]ZHANG X,ZHU M,HE T,et al.Cardiac mechanics in isolated bicuspid aortic valve disease with normal ejection fraction:a study of various valvular lesion types[J].Medicine(Baltimore),2015,94(47):e2085.
[13]TZEMOS N,SILVERSIDES C K,CARASSO S,et al.Effect of pregnancy on left ventricular motion(twist)in women with aortic stenosis[J].Am J Cardiol,2008,101(6):870-873.
[2]KURT M,TANBOGA I H,BILEN E,et al.Abnormal left ventricular mechanics in isolated bicuspid aortic valve disease may be independent of aortic distensibility:2Dstrain imaging study[J].J Heart Valve Dis,2012,21(5):608-614.
[3]王新房.超声心动图学:4版[M].北京:人民卫生出版社,2012:333-351.
[4]CONG Z,JIANG B,LU J,et al.A potentially new phase of the cardiac cycle:Pre-isovolumic contraction recognized by echocardiography[J].Medicine(Baltimore),2018,97(21):e10770.
[5]于微,王小丛,赵丽蓉,等.超声三维斑点追踪技术评价原发性高血压患者左心室旋转和扭转[J].中国超声医学杂志,2012,28(6):519-522.
[6]MARCIO S,HECTWI R,MARIA C,et al.Global longitudinal strain or left ventricular twist and torsion?Which correlates best with ejection fraction[J].Arq Bras Cardiol,2017,109(1):23-29.
[7]伍婷婷,姜凡,张新书,等.二维斑点追踪技术评价蒽环类药物对乳腺癌化疗患者左室旋转及扭转功能影响[J].中国超声医学杂志,2014,12(3):1086-1089.
[8]宋家琳,黎春雷,童春,等.斑点追踪显像技术对正常成人左室扭转和解旋运动的初步研究[J].中国超声医学杂志,2007,23(9):665-667.
[9]MORA V,ROLDAN I,ROMERO E,et al.Comprehensive assessment of left ventricular myocardial function by two-dimensional speckle-tracking echocardiography[J].Cardiovasc Ultrasound,2018,16(1):16.
[10]HOLMES A A,TAUB C C,GARCIA M J,et al.Increased apical rotation in severe aortic stenosis is associated with reduced survival:a speckle-tracking study[J].J Am Soc Echocardiogr,2015,28(11):1294-1301.
[11]ZHANG H J,WANG H,SUN T,et al.Assessment of left ventricular twist mechanics by speckle tracking echocardiography reveals association between LV twist and myocardial fibrosis in patients with hypertrophic cardiomyopathy[J].Int J Cardiovasc Imaging,2014,30(8):1539-1548.
[12]ZHANG X,ZHU M,HE T,et al.Cardiac mechanics in isolated bicuspid aortic valve disease with normal ejection fraction:a study of various valvular lesion types[J].Medicine(Baltimore),2015,94(47):e2085.
[13]TZEMOS N,SILVERSIDES C K,CARASSO S,et al.Effect of pregnancy on left ventricular motion(twist)in women with aortic stenosis[J].Am J Cardiol,2008,101(6):870-873.