论文部分内容阅读
目的应用应变率成像(SRI)结合组织速度(TVI)显像技术评价持续性房颤患者左心耳机械运动特点以及变化特点。方法对29例患者和31例对照者行经食管超声检查,比较各节段运动速度(PSV和PDVE)以及局部心肌沿长轴的应变率(Ssr和Dsr)变化特点。结果对照组左心耳壁顶部Ssr、Dsr、PSV和PDVE均高于其余节段(P<0.01,0.05)。房颤组左心耳顶部Ssr、PSV仅高于间隔壁及侧壁中段(P<0.05),心耳顶部Dsr仅高于间隔壁中段(P<0.05)。对照组心耳顶部Ssr、PSV与左心耳面积变化率(LAA-EF)和左心耳充盈速度(LAA-EV)呈正相关(r=0.724、0.637、0.656、0.712,P<0.001),房颤组心耳顶部PSV与LADd呈线性负相关(r=-0.66,P<0.001)。房颤组各节段Ssr、Dsr、PSV以及PDVE较对照组均降低(P<0.01)。结论左心耳顶部Ssr以及PSV决定了心耳整体的排空能力,房颤患者由于心耳壁舒缩功能明显降低导致的心耳壁运动不协调。TVI和SRI技术相结合,能更为全面地反映左心耳功能变化特点。
Objective To evaluate the characteristics and changes of left atrial appendage mechanics in patients with persistent atrial fibrillation by using strain rate imaging (SRI) combined with tissue velocity (TVI) imaging. Methods Twenty-nine patients and 31 control subjects underwent transesophageal echocardiography. The changes of PSV and PDVE and the strain rate (Ssr and Dsr) of local myocardium along the long axis were compared. Results The Ssr, Dsr, PSV and PDVE at the top of the left atrial appendage in the control group were significantly higher than those in the other segments (P <0.01, 0.05). The Ssr and PSV at the apical portion of the left atrial appendage in AF group were only higher than those in the middle and medial segment of the atrial appendage (P <0.05). The Dsr at the apical portion of the atrial appendage was only higher than that in the middle segment of the atrial septum (P <0.05). There was a positive correlation between Ssr, PSV and LAA-EF and LAA-EV in the control group (r = 0.724,0.637,0.656,0.712, P <0.001) There was a linear negative correlation between apical PSV and LADd (r = -0.66, P <0.001). Ssr, Dsr, PSV and PDVE in each segment of AF group were lower than those in control group (P <0.01). Conclusions Ssr and PSV at the top of left atrial appendage determine the evacuation ability of the atrial appendage. The atrial appendage movement is not coordinated due to the significant reduction of atrial appendage diastolic function. TVI and SRI technology combined to more fully reflect the characteristics of left atrial appendage changes.