摘要
目的采用超声二维斑点追踪技术(STE)检测二尖瓣乳头肌(MVPM)的同步性,探讨心脏再同步化治疗(CRT)对二尖瓣反流(MR)的作用机制。方法对伴MR接受CRT治疗的25例心力衰竭患者,术前3天和术后7天在CRT开启和关闭状态下进行超声检查,测量MR最大面积与左心房面积的比值(MRA/LAA)、左心室整体重构参数、局部重构参数及二尖瓣形态参数;STE测量左心室短轴二尖瓣乳头肌所在心肌节段达峰值径向应变的时间差(TAPM-PPM),并探讨以上参数与MR的关系。结果术后MRA/LAA显著减小,左心室整体和局部重构参数及二尖瓣形态参数均改善,TAPM-PPM缩短;而CRT关闭后这些作用消失。TAPM-PPM是MR减少的最有力的独立影响因素。结论CRT可即刻减少MR,其作用机制可能与改善二尖瓣乳头肌同步性有关。STE能准确检测MVPM同步性。
Objective To test the value of two-dimensional speckle tracking echocardiography （STE） in evaluation on the mechanism for reduction in mitral regurgitation （MR） after cardiac resynchronization therapy （CRT）. Methods Twenty- five heart failure patients with MR scheduled for CRT were included. All patients underwent echocardiography 3 days preoperation and 7 days after implantation with device ON and OFF. The ratio of mitral regurgitation area to the left atrial area （MRA/LAA）, left ventricular （LV） global remodeling, local remodeling, mitral deformation, mitral valve papillary muscle （MVPM） where the myocardial segments reached the peak radial strain of the time difference （TAPM- PPM） were assessed, and the relationship between these parameters and severity of MR was analyzed. Results Reductions of MRA/LAA, improvement of LV global remodeling and local remodeling, TAPM- PPM shortening after CRT were observed, but these beneficial effects disappeared at CRT-OFF. TAPM- PPM was the strongest impact factor of reduction of MRA/LAA. Conclusion CRT can immediately and significantly reduce MR, and the improved synchrony of MVPM appears to be a contributor to reduce MR. STE is a reliable technique to assess the synchrony of MVPM.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第5期859-862,共4页
Chinese Journal of Medical Imaging Technology
基金
辽宁省教育厅科学技术研究基金(No.2008748)
关键词
超声心动描记术
二维斑点追踪
二尖瓣反流
Echocardiography
Two dimensional speckle tracking
Mitral regurgitation
