摘要
目的 探讨定量组织速度成像(QTVI)评价充血性心力衰竭(CHF)患者左心室心肌的非同步性运动及其与左心功能、QRS间期的关系。方法 正常人和CHF患者各40例,利用QTVI技术,获取标准心尖部左室长轴、两腔和四腔观,获得左心室6个壁基底段、中间段和心尖段共18个位点的多普勒速度曲线,测量各位点QRS波起始至心肌收缩期峰值速度和舒张早期峰值速度的时限(TS和TE)。计算同一节段6个壁间TS和TE的最大差值(Inter ΔTS和Inter ΔTE)、同一壁内3个节段间TS和TE的最大差值(Intra ΔTS和Intra ΔTE)及左心室18个位点间TS和TE的最大差值(Max ΔTS和Max ΔTE)。同时计算二尖瓣环6个位点收缩期峰值速度和舒张早期峰值速度的均值(MeanVs和MeanVe)及左心室射血分数(LVEF)。结果 CHF组Inter ΔTS、Inter ΔTE、Intra ΔTS、Intra ΔTE、Max ΔTS和Max ΔTE较正常组明显延长(均P<0. 05 );CHF组Max ΔTs与LVEF、MeanVs负相关(r= -0. 761, P<0. 01; r= -0. 738, P<0. 01),与QRS间期不相关; Max ΔTE与QRS间期正相关(r=0. 470,P<0. 01),与MeanVe负相关(r=-0. 656,P<0. 01)。结论 CHF患者左心室同一节段及同一壁内均存在非同步运动,且与左心功能、QRS间期关系密切。
Objective To evaluate the asynchrony of the different segments of left ventricle(LV) and its relation with LV function, QRS duration in the patients with congestive heart failure(CHF) by quantitative tissue velocity imaging(QTVI). Methods Forty normal controls and 40 patients with CHF were studied by QTVI. The regional velocity profiles of 18 segments of LV along LV apical long axis view, apical two chamber view and four chamber view were obtained. The time from onset of QRS complexes to peak velocity during systole and early diastole (T S and T E) were measured. The maximal difference in T S and T E within the same wall (Intra ΔT S and Intra ΔT E), the same segment (Inter ΔT S and Inter ΔT E ) and all 18 segments(Max ΔT S and Max ΔT E ) of LV were calculated. The parameters of LV function calculated included the mean of mitral annulus systolic peak velocities and early diastolic peak velocities of six wall(Mean Vs and Mean Ve), and ejection fraction of LV(LVEF). Results Inter ΔT S,Inter ΔT E,Intra ΔT S,Intra ΔT E,Max ΔT S and Max ΔT E in CHF group were significantly prolonged, all showing statistic significance when compared with control group(all P< 0.05 ). In CHF group, Max ΔT S was correlated negatively with LVEF, Mean Vs respectively(r= -0.761 ,P< 0.01 ; r= -0.738 ,P< 0.01 ),and not correlated with QRS duration. In diastole, Max ΔT E was correlated positively with QRS duration(r= 0.470 ,P< 0.01 ),while correlated negatively with mean Ve(r= -0.656 ,P< 0.01 ). Conclusions Asynchrony exists within the same wall and the same segment of LV, having good relation with LV function and QRS duration in the patients with CHF.
出处
《中华超声影像学杂志》
CSCD
2005年第4期264-267,共4页
Chinese Journal of Ultrasonography
关键词
心力衰竭
心室非同步运动
定量组织速度成像
QRS间期
心功能
Echocardiography
Heart failure,congestive
Ventricular function,left
Quantitative tissue velocity imaging
