二维斑点追踪成像评价心脏移植术后左室收缩同步性的价值探讨

易仁凤; 周燕翔; 宋宏宁; 姜楠; 蔡迪; 郭瑞强

doi:10.16245/j.cnki.issn1008-6978.2020.02.011

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二维斑点追踪成像评价心脏移植术后左室收缩同步性的价值探讨

临床研究 | 更新时间：2021-10-08

- 二维斑点追踪成像评价心脏移植术后左室收缩同步性的价值探讨
- Two-dimensional speckle tracking echocardiography in evaluating left ventricular systolic synchronization after heart transplantation
- 临床超声医学杂志 2020年22卷第2期页码：108-112
- 作者机构：
  
  武汉大学人民医院超声影像科
- 作者简介：
- 基金信息：
  
  武汉大学自主科研资助项目（2042019kf0089）
- DOI：10.16245/j.cnki.issn1008-6978.2020.02.011
  中图分类号： R540.45;R654.2
- 纸质出版日期：2020，
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[1]易仁凤,周燕翔,宋宏宁,姜楠,蔡迪,郭瑞强.二维斑点追踪成像评价心脏移植术后左室收缩同步性的价值探讨[J].临床超声医学杂志,2020,22(02):108-112.

YI Renfeng, ZHOU Yanxiang, SONG Hongning, et al. Two-dimensional speckle tracking echocardiography in evaluating left ventricular systolic synchronization after heart transplantation[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(2):108-112.
[1]易仁凤,周燕翔,宋宏宁,姜楠,蔡迪,郭瑞强.二维斑点追踪成像评价心脏移植术后左室收缩同步性的价值探讨[J].临床超声医学杂志,2020,22(02):108-112. DOI： 10.16245/j.cnki.issn1008-6978.2020.02.011.

YI Renfeng, ZHOU Yanxiang, SONG Hongning, et al. Two-dimensional speckle tracking echocardiography in evaluating left ventricular systolic synchronization after heart transplantation[J]. Journal of Clinical Ultrasound in Medicine, 2020,22(2):108-112. DOI： 10.16245/j.cnki.issn1008-6978.2020.02.011.

摘要

目的应用二维斑点追踪成像评价临床状态稳定的心脏移植患者术后左室收缩同步性。方法选取20例心脏移植后无并发症且临床状态稳定的患者（心脏移植组）

于移植术后3 d、1个月、3个月、6个月和1年行超声心动图检查;另选20例正常成人（对照组）。应用二维斑点追踪成像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、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）

同时应用改良Simpson双平面法测量左室射血分数（LVEF）。比较心脏移植组各时间段与对照组间、心脏移植组各时点间上述参数的差异。结果心脏移植组术后3 d各应变参数均较对照组显著增高

差异均有统计学意义（均P<0.05）;术后1个月Tls-SD与对照组比较差异有统计学意义（P<0.05）。心脏移植组术后LSDI、Tls-SD、Tls-dif呈逐渐降低趋势

且术后3 d与术后3个月、6个月、1年比较

差异均有统计学意义（均P<0.05）;术后1个月Tls-SD与术后1年比较差异有统计学意义（P<0.05）。术后各时间段LSDI、Tls-SD和Tls-dif与LVEF均呈负相关（r=-0.523、-0.434、-0.401

均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

以术后3 d最为显著

在术后3个月左室收缩同步性得以恢复

并趋向正常。二维斑点追踪成像测得的LSDI、Tls-SD、Tls-dif可以客观评价心脏移植术后左室收缩同步性的变化

且以上参数与LVEF显著相关。

Abstract

Objective To evaluate left ventricular systolic synchronization in the patients with stable clinical stateafter heart transplantation in by two-dimensional speckle tracking technique（2D-STE）.MethodsA total of 20 patients with stable clinical status after heart transplantation were selected（heart transplantation group）.Echocardiography was performed at3 d

1 month

3 months

6 months and 1 year after heart transplantation

and 20 normal subjects were collected as control group.The longitudinal strain

radial strain and circumferential strain at peak time（Tls

Trs

Tcs）of each segment of left ventricle wereobtained by 2 D-STE.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 at peak time of left ventricle were calculated.Thelongitudinal strain delay index（LSDI）was calculated

and the left ventricular ejection fraction（LVEF）was measured by modifiedSimpson biplane method.ResultsThe strain parameters of heart transplantation group were significantly higher than those ofcontrol group at 3 d after heart transplantation（all P<0.05）.There was significant difference in Tls-SD between 1 month heartafter transplantation and control group（P<0.05）. In the heart transplantation group

the LSDI

Tls-SD

Tls-dif decreasedgradually after operation

and there were significant differences between the 3 d and 3 months

6 months

1 year aftertransplantation（all P<0.05）.There was significant difference in Tls-SD between 1 month and 1 year after sransplantation（P<0.05）.In the transplantation group

there were significant negative correlations between LSDI

Tls-SD Tls-dif and LVEF（r=-0.523

-0.434

-0.401

all P<0.01）

and the correlation coefficient of LSDI was the highest.Conclusion The left ventricular systolic function of patients with stable clinical state after heart transplantation is not synchronous

the mostsignificant is the 3 d after transplantion.After 3 months of transplantation

the synchronization of left ventricular systolic functiontends to be normal.In the 2 D-STI synchronization parameters

LSDI、Tls-SD

Tls-dif can objectively evaluate the changes of leftventricular systolic synchronization after the heart transplanted

and the above parameters have significant correlation with LVEF.

关键词

斑点追踪成像二维心脏移植同步性心室左

Keywords

Speckle tracking imagingtwo-dimensionalHeart transplantationSynchronizationventricleleft

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