摘要
目的 应用二维超声斑点追踪技术评价主动脉瓣狭窄（AS）患者瓣膜置换术前后左室旋转及扭转功能.方法 选取28例射血分数（LVEF）正常的重度主动脉瓣狭窄患者,应用斑点追踪技术测量瓣膜置换术前及术后（AVR）6个月的左室旋转角度,并计算扭转角度.测量结果与28例正常对照者进行比较.结果 与正常对照组相比,病例组术前心尖旋转角度明显增加[（13.0±5.8）°对（7.6±2.6）°,P＜0.001],心底旋转角度不变,致左室整体扭转角度增加[（19.7±5.7）°对（12.9±3.2）°,P＜0.001].术后6个月,心尖旋转角度及左室扭转角度均恢复至正常水平.左室扭转角度与左室短轴缩短分数（LVFS）在正常对照组显著相关（r =0.81,P＜0.001）,在病例组相关性减低（r =0.52,P＜0.01）,AVR术后相关性则完全消失（r =0.34,P＞0.05）.结论 LVEF正常的重度主动脉瓣狭窄患者左室心尖旋转角度增加,致左室扭转角度明显增加,虽然瓣膜置换术后可恢复正常,却失去了与左室短轴基底部收缩功能的相关性.
Objective To assess the effect of aortic valve replacement （AVR） on left ventricular （LV） twist function in severe aortic stenosis （AS） patients with preserved LV ejection fraction （LVEF） by speckle tracking imaging （STI）.Methods Twenty-eight severe aortic stenosis （AS） patients （17 male,age 64.1 ± 10.4 years） with normal LVEF （≥50％） were examined by STI before and six months after AVR.The standard mitral valve and apical short-axis views were obtained to analyze LV basal and apical peak systolic rotation.LV peak systolic twist was calculated as the different between apical rotation and basal rotation.LV fractional shortening （LVFS） was calculated as the percentage fall of LV systolic dimension with respect to diastolic dimension.The data were compared with 28 age and sex-matched normal controls.Results In patients,LVEF remained unchanged after AVR.LV twist increased before （19.7° ± 5.7° vs 12.9° ± 3.2°,P ＜0.001） because of increased apical rotation （13.0° ± 5.8° vs 7.6° ± 2.6°,P ＜0.001）,and normalized after AVR （14.4°± 5.2°,P ＜0.001）.In controls,LV twist correlated with LVFS （r =0.81,P ＜ 0.001）,this relationship was reversed in patients before （r =0.52,P ＜0.01） and after AVR （r =0.34,P ＞0.05）.Conclusions In patients with severe AS and normal LVEF,LV twist is exaggerated suggesting potential compensation for reduced long axis function.These disturbances normalize within six months of AVR but lose their relationship with basal LV function.
出处
《中华超声影像学杂志》
CSCD
北大核心
2013年第10期834-837,共4页
Chinese Journal of Ultrasonography
基金
国家自然科学基金资助项目（81200166）
2013年度北京市留学人员科技活动择优资助项目
关键词
超声心动描记术
主动脉瓣狭窄
心脏瓣膜假体植入
心室功能
左
斑点追踪显像
Echocardiography
Aortic valve stenosis
Heart valve prosthesis implantation
Ventricular function, left
Speckle tracking imaging
