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目的探讨斑点追踪技术描述肥厚型心肌病(HCM)左室局部收缩同步性情况及收缩后收缩现象(PSS)出现情况临床价值。方法选择2008年1月至12月上海华东医院HCM患者18例,年龄21～78岁。同期就诊的正常人36名为对照组,年龄19～76岁。采用GE-VIVID7超声诊断仪,选取超声心动图短轴二尖瓣水平、乳头肌水平及心尖水平切面观,运用斑点追踪技术取得不同水平不同节段的径向应变/应变率及圆周应变/应变率曲线,分别计算圆周及径向应变收缩期达峰时间,并观察PSS。结果 HCM组与对照组圆周方向和径向方向达峰时间分别为(398±28)ms对(378±57)ms(P<0.05)和(418±52)ms对(370±51)ms(P<0.001),HCM组与对照组圆周及径向应变达峰时间分别为(80±27)ms对(48±18)ms(P<0.001)和(91±19)ms对(41±14)ms(P<0.001),均较对照组延长。HCM组增厚节段和未增厚节段达峰时间以及达峰时间标准差差异无统计学意义。HCM组PSS较正常组增加,多集中在基底段和心尖段,增厚节段出现PSS较非增厚节段显著增加。结论 HCM左室收缩不同步性显著,PSS明显增加。斑点追踪技术能较好地评价HCM不同运动方向上的心肌同步性情况。
Objective To investigate the clinical significance of speckle tracking in describing the synchronous left ventricular systolic and systolic contraction (PSS) in patients with hypertrophic cardiomyopathy (HCM). Methods 18 patients with HCM in Shanghai Huadong Hospital from January 2008 to December 2008 were selected, ranging in age from 21 to 78 years. 36 normal subjects visited the same period as the control group, aged 19 to 76 years. Using GE-VIVID7 ultrasonic diagnostic apparatus, the echocardiographic short axis mitral valve level, papillary muscle level and apical level section view were selected. The radial strain / strain rate and circumferential strain / strain Rate curve, calculate the peak and radial strain systolic peak time, and observe the PSS. Results The peak time in the circumferential and radial directions of HCM group and control group were (398 ± 28) ms versus 378 ± 57 ms and 418 ± 52 ms vs 370 ± 51 ms respectively (P <0.001), and the peak time of circumferential and radial strain in HCM group and control group were (48 ± 18) ms vs (81 ± 19) ms vs ) ms (P <0.001), were longer than the control group. HCM group thickening and non-thickening of the peak time and peak time difference between the standard deviation was not statistically significant. PSS in HCM group increased more than normal group, mostly concentrated in basal segment and apical segment, PSS in thickening segment increased significantly compared with non-thickened segment. Conclusions HCM left ventricular contraction is not synchronous, PSS increased significantly. Spots tracking technology can better evaluate the HCM in different directions of myocardial synchronization.