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三维心肌应变—临床评估左室收缩功能的新指标
Three-Dimensional Echocardiography Speckle-Tracking Strain—New and promising parameter for the assessment of left ventricular systolic function
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DOI:
作者:
陈晖、徐迎佳、吴卫华、郭丽娜、方唯一
Chen Hui, Xu Ying-jia, Wu Wei-hua, Guo Li-na, Fang Wei-yi
作者单位:
上海市胸科医院 心内科 超声科
Division of Cardiology, Department of Echocardiography, Shanghai Chest Hospital, Jiao Tong University
关键词:
斑点追踪显像;三维应变;收缩功能;左室
Three-Dimensional Echocardiography;Speckle-Tracking Strain;Systolic function;Left ventricule.
摘要:
目的 探讨用三维斑点追踪显像(3D-STI)技术测得的心肌应变及位移在定量评估左室收缩功能方面的应用价值。方法 健康志愿者共72例,用Phillip Sonos iE33超声仪,经胸超声分别采集并储存三维(3D)全容积动态图像及二维(2D)图像,然后输入TomTec工作站,分别用四维左室功能(4D LVF3.0)及Cardiac Performance Analysis分析软件获取左室3D及2D应变、位移各值及3D-LVEF等参数,并将这二种方法测得的应变及位移各测值与3D-LVEF间进行相关性分析。结果 3D与2D在左室纵向(LS及LD)、径向(RS及RD)、环向(CS及CD)上的应变及位移测值之间均有显著差异(P<0.001);3D在各个方向上16节段应变峰值的均值与3D-LVEF间均有良好的相关性(相关系数0.77~0.86,P均<0.001),明显好于2D应变各测值(相关系数0.35~0.53,P均<0.005),特别是三维整体应变(3DS)与3D-LVEF的相关系数达到0.88;在位移各值中、3D与2D均仅有部分测值与3D-LVEF之间呈一定的相关性。所有参数在观察者内及观察者间的可重复性均较高。结论 三维应变较位移能更客观和准确地反映心肌的运动,尤其是3DS可以作为临床评价左室收缩功能的一个新指标。
Objectives To measure left ventricular myocardial strain and displacement values by using three-dimensional speckle tracking imaging(3D-STI)and to correlate 2D, 3D strain and displacement values with left ventricular systolic function. Methods Transthoracic echocardiography was performed on 72 healthy volunteers using Phillip Sonos iE33. 2D and 3D full-volume images were obtained and then transferred to TomTec workstation. 2D, 3D left ventricular strains, displacement and 3D-LVEF were analyzed under the use of four-dimensional left ventricular function software (4D LVF3.0) and Cardiac Performance analysis software. Correlations between these measurements and 3D-LVEF were calculated by SPSS 15.0. Results There were significant difference(P<0.001)in all left ventricular longitudinal (LS and LD), radical (RS and RD), circumferential (CS and CD) stains and displacements between 2D and 3D. The mean peak 3D strains of 16 segments on each vector exhibited a relatively high correlation with 3D LVEF(correlation coefficient 0.77 ~ 0.86, P < 0.001), which was significantly higher than the 2D strains (correlation coefficient 0.35 ~ 0.53, P < 0.005). Specially, the correlation coefficient reached 0.88 between global three-dimensional strain (3DS) and 3D LVEF. Part of measurements of 3D and 2D displacements correlated with 3D LVEF. The intra-observer and inter-observer reproducibility analysis showed fairly good results. Conclusions The 3D strain might reflect the myocardial motion more objectively and accurately than displacement. 3DS appeared to be a new and promising parameter for the assessment of left ventricular systolic function.
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