文章摘要
雍永宏,庄 燕,姚 静,杨 荣,盛燕辉,周 蕾,许 迪,曹克将.二维斑点追踪技术评价房间隔缺损封堵术前后右室应变及应变率的变化[J].南京医科大学学报,2009,29(8):1128~1132
二维斑点追踪技术评价房间隔缺损封堵术前后右室应变及应变率的变化
Evaluation the changes of strain rate and strain of right ventricular using speckle tracking imaging after transcatheter closure of atrtial septal defect
投稿时间:2009-03-20  
DOI:10.7655
中文关键词: 房间隔缺损  经皮封堵术  超声心动图  速度  应变  应变率  斑点追踪显像
英文关键词: ventricular septal defect  transcatheter closure  echocardiography  velocities  strain  strain rate  speckle tracking imaging
基金项目:国家自然科学基金资助项目(30772060)
作者单位
雍永宏 南京医科大学第一附属医院心内科,江苏 南京 210029 
庄 燕  
姚 静  
杨 荣  
盛燕辉  
周 蕾  
许 迪  
曹克将  
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中文摘要:
      目的:运用二维超声斑点追踪技术评价经皮房间隔封堵术前后患者右心室运动速度?应变及应变率的急性期变化?方法:检测25例房间隔缺损患者封堵术前?术后第3天的常规心脏二维多普勒超声参数,并运用二维斑点追踪技术对患者的右心室运动速度?应变及应变率进行分析,以探讨房间隔缺损封堵术对右心室运动的影响?25例年龄性别匹配的正常人作为对照?结果:房间隔缺损患者术前的右心室游离壁的运动速度较正常对照显著加快(P < 0.05),而封堵术后出现了明显的下降并且接近正常对照的运动速度(P > 0.05)?在房间隔缺损封堵术前,右心室游离壁的应变较正常对照升高(P < 0.05),右心室游离壁的应变率较正常对照升高但是差异无统计学意义(P > 0.05)?封堵术后,右心室游离壁的峰值应变及应变率出现下降趋势,但是较术前而言差异不显著(P > 0.05)?较正常对照而言,房间隔缺损患者术前室间隔的运动速度及峰值应变显著升高(P < 0.05),并且在术后出现显著的降低(P < 0.05)?而室间隔部位的应变率则未发现类似变化,无论和正常对照比较还是和术前比较,均未发现明显变化(P > 0.05)?结论:经皮室间隔缺损封堵术通过迅速减轻右心室的容量负荷而影响右心室的运动速度?应变及应变率?其中右心室的形变参数对右心室容量负荷的急性变化不敏感,而右心室的运动速度受负荷改变的影响明显?
英文摘要:
      Objective:To investigate the changes of right ventricular velocities,strain and strain rate in patients with atrial septal defect(ASD)after transcatheter closure. Methods:Using speckle tracking imaging(STI),the 6 segments of longitudinal peak systolic velocities,peak systolic strain rate(SR),and end systolic strain of the RV free wall and the septum were calculated repeatedly in 25 patients with ASD before surgery and the 3rd day after surgery,and 25 healthy subjects as controls. LVESV,LVEDV,LVSV,RVESV,RVEDV and RVSV were calculated. LV and RV ejection fraction(EF)was measured by Biplane Simpson method. Results:Compared with before closure of ASD,a significant reduction in RV long-axis dimension was noted in 72 hours after ASD closure. In patients with ASD,significantly higher peak systolic velocities were recorded from the RV free wall,compared with that in healthy control subjects. After transcatheter closure of the defect,we observed a significant reduction of peak systolic velocities,which returned to normal physiologic value. Before ASD closure,end systolic strain values were significantly higher,while peak systolic SR values showed a trend to increase,however,no significance compared with control. After transcatheter ASD closure,peak systolic SR and end systolic strain showed a diminishing tendency. However,the difference was not significant. In the patients with ASD,significant higher end systolic strain values and peak systolic velocities were found at the interventricular septum,followed by a significant reduction after ASD closure. Peak systolic SR did not differ significantly from normal values and remained unchanged after closure of the defect. Conclusion:RV longitudinal systolic deformation were not significantly influenced by chronic ventricular volume overload and sudden abolishment of this volume overload. These findings suggest that SR/S are relatively load-stable measures of contractile function in clinic. In contrast,myocardial velocities are load-dependent obviously.
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