应用分层应变技术评价心尖肥厚型心肌病患者左心室心肌圆周应变

摘要

目的 探讨分层应变技术评价心尖肥厚型心肌病(ApHCM)患者左心室圆周应变(CS)的临床价值.方法 选取20例ApHCM患者与30例健康对照者,获取各短轴水平超声图像,运用EchoPAC 113软件测量各水平心内膜下、中层及心外膜下心肌圆周应变峰值(CSendo、CSmid、CSepi),计算整体心内膜下、中层及心外膜下心肌圆周应变峰值(GCSendo、GCSmid、GCSepi).结果 (1) ApHCM组及对照组GCSendo、GCSmid、GCSepi呈梯度递减(P＜0.001);ApHCM组左心室GCSendo较对照组无统计学差异(P=0.381),GCSmid及GCSepi较对照组明显减低(P＜0.001).(2)与对照组相比,ApHCM组二尖瓣水平CSepi及乳头肌水平CSmid、CSepi减低(P＜0.05),心尖水平CSmid、CSepi显著减低(P＜0.001).结论 分层应变技术评价ApHCM患者左心室CS具有一定临床价值.%Objective To investigate the clinical value of layer-specific strain in evaluation of the circumferential strain(CS) of left ventricular in patients with apical hypertrophic cardiomyopathy (ApHCM) by using layer-specific strain.Methods A total of 20 patients with ApHCM and 30 healthy adults were included in the study.All standard measurements were obtained from all the left ventricular short-axis views.The CSendo,CSmid,CSepi in all the left ventricular short-axis views were measured by the offline EchoPAC 110 software and the GCSendo,GCSmid,GCSepi were calculated as well.Results (1)The GCSendo,GCSmid,GCSepi were reduced successively in patients with HCM and the control group.There was no statistical differences in GCSendo between patients with ApHCM and the control group(P=0.381).The GCSmid and GCSepi in patients with ApHCM were significant lower than in the control group (P＜0.001).(2)The CSepi at the level of mitral annulus as well as CSmid and CSepi at the level of papillary muscle in patients with ApHCM were lower than that in the control group (P＜0.001).The CSmid and CSepi at the level of apex in patients with ApHCM were significant lower than that in the control group(P＜0.001).Conclusions Layerspecific strain has certain clinical value in evaluating the circumferential strain of left ventricular in patients with ApHCM.