| 摘要: |
| 【摘要】 目的 应用二维斑点追踪成像(2D-STI)技术获取心肌应变参数,探讨心肌应变评价瓣膜病患者瓣膜置换术后临床短期疗效。方法 临床确诊心脏瓣膜病且行瓣膜置换术患者35例,正常对照组20例,且根据LS≥-20%定义为心肌运动功能异常节段,将瓣膜病术前的左室节段分为心肌运动功能正常节段和异常节段；获取左室整体及节段纵向、径向和环向应变参数。结果 瓣膜病患者在术后1周与术后1月时整体应变及整体分层应变参数均未见明显改善。与瓣膜置换术前比较,术后1月节段纵向应变(TLS)明显增高(P ＜0.05)；与术后1周比较,术后1月TLS明显增高；与术前比较,术后1周心内膜节段环向应变(TCSendo)明显减低(P ＜0.01),术后1月心内膜节段纵向应变(TLSendo)、心外膜节段纵向应变(TLSepi)明显增高(P＜0.01),TCSendo增高(P ＜0.05),心外膜节段环向应变(TCSepi)差异无统计学意义(P ＞0.05)；与术后1周比较,术后1月TLSendo、TLSepi明显增高(P＜0.01),TCSendo、TCSepi差异无统计学意义(P ＞0.05)。结论 2D-STI心肌应变参数能有效评估瓣膜病患者瓣膜置换术前以及术后临床短期疗效,具有一定的临床应用价值,其中心内膜心肌纵向应变是发现瓣膜病患者术后心功能恢复的敏感指标。 |
| 关键词: 超声心动描记术 心脏瓣膜病 瓣膜置换术 左心室功能 二维斑点追踪显像 |
| DOI： |
| 投稿时间：2017-06-19修订日期：2017-06-19 |
| 基金项目: |
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| Assessment of Clinical Outcome by Myocardial strain in Patients with Valve Replacement: A Short-term Follow-up Study |
| Lei Jiarui,Guo Ruiqiang |
| (Department of Ultrasound Imaging,Renmin Hospital of Wuhan University) |
| Abstract: |
| 【Abstract】Objective Myocardial strain of two-dimensional speckle tracking echocardiography (2D-STE) has been validated for cardiac function assessment. We sought to evaluate the changes of left ventricular (LV) myocardial strain of the global and regional longitudinal, radial and circumferential strain parameters in patients with valvular heart disease (VHD) and valve replacement for assessment of the clinical outcomes of VHD patients. Methods Thirty-five patients with VHD and valve replacement and twenty normal person were enrolled. LS less than -20% defines abnormal segments and layers of myocardium. 2D and strain variables of echocardiography were analyzed and compared with control group. Results Global and layer-specific longitudinal and circumferential strains were no significant improved in 1 week and 1 month after operation (P> 0.05). Compared with preoperative, territorial longitudinal strain (TLS) was significant improved in 1 month after operation (P <0.05), and it was also better than 1 week after operation (P <0.05). Territorial circumferential strain (TCS) of endocardial layer (TCSendo) was decreased which compared with preoperative. Territorial longitudinal strain (TLS) of endocardial and epicardial layers (TLSendo, TLSepi) were significantly improved in 1 month after operation while compared with preoperative (P <0.01), and TCSendo was also improved (P <0.05), Territorial circumferential strain (TCS) of epicardial layer (TCSepi) was no significant difference (P> 0.05). Compared with postoperative in 1 week, TLSendo, TLSepi were significantly improved in 1 month after operation (P <0.01) .There were no significant difference between 1 week and 1 month after operation by TCSendo and TCSepi (P> 0.05). Conclusion TLSendo is a sensitive indicator of the outcomes of VHD patients and better than LVEF and other strain variables by 2D-STE. Sensitive detection of LV dysfunction, especially myocardial strain parameters are valuable for the clinical therapeutic effect in short-term in patients with valve replacement. |
| Key words: Echocardiography Valvular heart disease Valve replacement Left ventricular function Two-dimensional speckle tracking imaging |
