| 摘要: |
| 【摘要】目的 应用二维斑点追踪技术（2D-STI）获取移植心脏左室收缩同步性参数，探讨临床状态稳定的心脏移植患者术后左室收缩同步性的变化。方法 随访20例心脏移植后无并发症临床状态稳定的患者于移植术后3天、1个月、3个月、6个月和1年进行超声心动图检查，另收集20例正常人作为对照。采用斑点追踪技术获取左室各节段纵向应变、径向应变及圆周应变达峰时间（Tls、Trs、Tcs）,计算左室整体收缩期纵向应变、径向应变及环向应变达峰时间标准差(Tls- SD，Trs- SD，Tcs- SD)及达峰时间最大差值(Tls-dif，Trs-dif，Tcs-dif)，并计算纵向应变延迟指数(LSDI)，同时运用改良Simpson双平面法测量左室射血分数（LVEF）。结果 心脏移植术后3天组各组应变参数均较对照组显著增高，差异具有统计学意义（P＜0.05）。移植后1月组Tls-SD较对照组差异有统计学意义（P＜0.05）。移植术后各组间比较，LSDI，Tls-SD，Tls-dif在术后呈逐渐降低的趋势，且移植后3天组较3月、6月及1年组比较差异有统计学意义（P＜0.05），Tls-SD在移植后1月组较1年组比较差异有统计学意义（P＜0.05）。移植术后各组 LSDI、Tls-SD和Tls-dif与LVEF 呈显著负相关（P＜0.01），其中LSDI相关系数最高。结论 临床状态稳定的心脏移植术后患者左室收缩功能存在不同步性，且以移植后3天组最为显著，在移植术后3月左室收缩同步性得以恢复，并趋向正常，较对照组差异已无统计学意义（P＜0.05），在2D-STI同步性参数中LSDI、Tls-SD、Tls-dif可以客观评价移植心脏左室收缩同步性且与LVEF有显著的相关性。 |
| 关键词: 心脏移植 左室同步性 斑点追踪 |
| DOI： |
| 投稿时间：2019-08-12修订日期：2020-01-10 |
| 基金项目:武汉大学自主科研资助项目 |
|
| Two dimensional speckle tracking echocardiography evaluation of the change left ventricular systolic synchronization after heart transplantation |
| YIRENFENG |
| (Renmin Hospital of wuhan University) |
| Abstract: |
| [abstract] objective Application two-dimensional speckle tracking technique (2D-STE) to obtain left ventricular systolic synchronization parameters，evaluating the changes of left ventricular systolic synchronization and its correlation with left ventricular ejection fraction （LVEF） in the patients with stable clinical state after heart transplantationin. Methods Echocardiography was performed in 20 heart transplantation patients with stable clinical status without complications in 3 days, 1 month, 3 months, 6 months and 1 year after heart transplantation ，and 20 normal subjects were collected as control. The longitudinal strain, radial strain and circumferential strain peak time （Tls,Trs,Tcs） of each segment of left ventricle were obtained by spekle tracing imaging technique. Calulateing the standard deviations （Tls-SD,Trs-SD,Tcs-SD）and the maximum difference of peak time （Tls-dif,Trs-dif,Tcs-dif）of longitudinal strain、radial strain and circumferential strain peak time of left ventricle . And the longitudinal strain delay index （LSDI） was calculated and the left ventricular ejection fraction （LVEF）was measured by modified Simpson biplane method. Results The strain parameters of each group were significantly higher than control group on the 3-day group after heart transplantation （P < 0.05）. There was a significant difference in Tls-SD between 1-month group and control group after operation （P < 0. 05）. Compared with each group after transplantation, LSDI,Tls-SD,Tls-dif decreased gradually after operation, and there was significant difference between the 3-day group and 3-month, 6-month 、1-year group （P < 0.05）. There was a significant difference between 1 month group and 1 year group （P< 0 05）in Tls-SD paramete . In the transplantation group there was a significant negative correlation between LSDI,tssl-SD Tls-dif and LVEF （P < 0 01）, and the correlation coefficient of LSDI was the highest in the transplantation group （P < 0 01）.Conclusion The left ventricular systolic function of patients with stable clinical state after heart transplantation was not synchronous,the most significant was the 3-day group after transplantion.With the recovery of cardiac function, after 3 months of operation the synchronization of left ventricular systolic function tended to be normal. In the 2D- STI synchronization paramete ，LSDI、Tls-SD,、Tls-dif can objectively evaluate the left ventricular systolic synchrony after the heart transplanted . |
| Key words: Echocardiography Heart transplantation Left ventricular synchronization Speckle tracking imaging |
