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目的应用超声二维斑点追踪显像(STI)技术评价孤立性心肌致密化不全(IVNC)患者左心室局部心肌收缩功能。方法对34例IVNC患者(IVNC组)及28名健康志愿者(对照组)进行超声检查,分析左心室二尖瓣、乳头肌、心尖水平短轴切面及心尖左心室长轴、四腔、两腔切面连续3个心动周期的二维灰阶图像。按照18节段划分法,记录左心室各节段心肌径向(Sr)、圆周(Sc)、纵向(εS)收缩期峰值应变,并将受累节段与未受累节段及对照组同水平相应节段进行比较。结果①与对照组比较,IVNC组左心室所有节段心肌Sr、Sc、εS均减低(P<0.05)。②IVNC组非致密心肌(乳头肌及心尖水平)Sr、Sc、εS测值较同一水平致密心肌减低(P<0.05)。③与对照组比较,IVNC组心率、LADs、LVEDD、LVM、LVMI、EDV、ESV值均增加,IVSd、LVPWDd、LVEF值均减小(P<0.01)。结论 IVNC患者左心室局部心肌收缩功能减低,以受累节段收缩功能减低尤为明显。STI技术可准确定量分析IVNC患者左心室局部心肌收缩功能。
Objective To evaluate left ventricular regional systolic function in patients with isolated myocardial densification (IVNC) by two-dimensional speckle tracking imaging (STI). Methods Thirty-four patients with IVNC (IVNC group) and 28 healthy volunteers (control group) underwent ultrasonography. The left ventricular mitral valve, papillary muscle, apical short axis view and apical left ventricular long axis, Two-dimensional gray-scale images of three consecutive cardiac cycles in the lumenal section. According to the 18-segment classification, the peak radial strain (SR), the circumferential direction (Sc) and the longitudinal (εS) systolic peak strain of the left ventricular segments were recorded, and the affected segments were matched with the unaffected segments and the control group Segments are compared. Results ① Compared with the control group, the levels of Sr, Sc and εS in all segments of left ventricle in IVNC group decreased (P <0.05). (2) The values of Sr, Sc, εS in non-dense myocardium (papillary muscle and apical level) in IVNC group were lower than those in the same level of dense myocardium (P <0.05). ③Compared with the control group, the heart rate, LADs, LVEDD, LVM, LVMI, EDV and ESV of IVNC group increased and IVSd, LVPWDd and LVEF values decreased (P <0.01). Conclusions The left ventricular myocardial systolic function was decreased in patients with IVNC, and the systolic function of the affected segments was significantly reduced. STI technique can accurately quantify left ventricular regional myocardial systolic function in patients with IVNC.