| 摘要: |
| 目的 应用实时三维超声心动图（RT-3DE）和二维斑点追踪成像技术（2D-STI）评价肥厚型心肌病（HCM）患者的左房功能。方法 选取肥厚型心肌病患者49例（HCM组），健康志愿者33例（正常对照组），应用RT-3DE分别测量左房最大容积（LAVmax）、左房最小容积（LAVmin）、左房收缩前容积（LAVpre）、经体表面积（BSA）矫正，计算出左房容积指数（LAVI）、左房射血分数（LAEF）、左房被动射血分数（LAPEF）和左房主动射血分数（LAAEF）；应用2D-STI获得左房各壁（房间隔、侧壁、前壁、下壁、后壁）中间段长轴方向的心肌运动应变率曲线，测量左房各壁中间段左室收缩期峰值应变率（SRs）、左室舒张早期峰值应变率（SRe）和舒张晚期峰值应变率（SRa），计算其平均值（mSRs、mSRe、mSRa），比较两组上述各参数的差异。分析LAEF与mSRs、LAAEF与mSRa、LAPEF与mSRe间的相关性。结果 与正常对照组比较，HCM组LAVImax、LAVImin、LAVIpre、LASV均增大，LAEF、LAPEF均减小，差异均有统计学意义（均P＜0.05），LAAEF较正常对照组减小，但差异无统计学意义。与正常对照组比较，HCM组左房的房间隔、侧壁、前壁、后壁中间段的SRs、mSRs，房间隔、侧壁、前壁、下壁、后壁中间段的SRe、mSRe、SRa、mSRa均减小，差异均有统计学意义（均P＜0.05）。mSRe与LAPEF、mSRa与LAAEF，以及mSRs与LAEF均呈正相关（r=0.608、0.314、0.396，均P＜0.05）。结论 应用RT-3DE结合2D-STI技术可以准确测定HCM患者左房容积增大，左房辅泵功能、管道功能和储蓄功能的相互代偿作用减弱或消失，具有很好的临床应用价值。 |
| 关键词: 超声心动描记术，三维，实时 斑点追踪成像，二维 肥厚型心肌病 心房功能，左 |
| DOI： |
| 投稿时间：2017-11-17修订日期：2018-10-06 |
| 基金项目:福建省科委省自然科学基金项目（2015J01431） |
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| Evaluation of Left Atrial Function in Patients with Hypertrophic Cardiomyopathy by Real-Time Three-Dimensional Echocardiography and Two-Dimensional Speckle Tracking Imaging |
| chen bin |
| (fujian provincial hospital) |
| Abstract: |
| Objective To evaluate Left atrial function by real-time three-dimensional echocardiography （RT-3DE） and two-dimensional speckle tracking imaging （2D-STI） in patients with hypertrophic cardiomyopathy（HCM） .Methods Our work included 2 groups as HCM group，n=49 patients and control group，n=33 healthy volunteers. Left atrial maximal volume（LAVmax），left atrial minimal volume （LAVmin），left atrial presystolic volume（LAVpre） were calculated by RT-3DE.Then the Left atrial volume index（LAVI）was calculated by dividing the body surface area（BSA），and left atrial stroke volume（LASV），left atrial total ejection fraction（LAEF），left atrial passive ejection fraction（LAPEF），left atrial active ejection fraction（LAAEF） were calculated. Two-dimensional images were acquired from the apical four chamber view，two-chamber view and apical three-chamber view to retain images for offline analysis.The systolic，early and late diastolic peak strain rate （SRs，SRe，SRa）curves were acquired in each middle segment of left atrium（septal，lateral，anterior，inferior and posterior ） by 2D-STI.And the average strain rate was calculated （mSRs，mSRe，mSRa），then the differences of above parameters between the two groups were compared.Finally，the correlation analysis between LAEF and mSRs，LAAEF and mSRa，LAPEF and mSRe were performed.Results LAVImax，LAVImin，LAVIpre were increased in HCM group than normal group，meanwhile LAEF and LAPEF were decreased. SRs of left atrial wall except inferior，mSRs，SRe of left atrial wall，mSRe，SRa of left atrial wall and mSRa were reduced compared with normal group（P＜0.05）.There was a positive correlation between mSRe and LAPEF，mSRa and LAAEF，and between mSRs and LAEF （r=0.608，0.314，0.396，P＜0.05）.Conclusions RT-3DE combined with 2D-STI can accurately determine the left atrial volume in patients with HCM，and the compensatory effects of left atrial pump function，conduit function and reservoir function are weakened or disappeared，which has a good clinical application value. |
| Key words: Real-time three-dimensional echocardiography,Two-dimensional speckle tracking imaging,Hypertrophic Cardiomyopathy(HCM) ,Left atrial function |
