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目的探讨实时三维超声心动图(RT-3DE)和二维斑点追踪显像(2D-STI)评价心肌缺血和心肌梗死患者左室整体收缩功能和同步性的临床应用价值,及两种方法在评价左室收缩同步性方面的相关性。方法 46例心肌缺血患者(心肌缺血组)、44例心肌梗死患者(心肌梗死组)和60例健康志愿者(正常对照组)行RT-3DE和2D-STI检查,应用Qlab8.1软件脱机分析,获得左心室收缩功能参数:GLS、GCS、GRS、3D-LVEDV、3D-LVESV和3D-LVEF;同步性参数:Tls-l6-SD、Trs-l2-SD、Tcs-l2-SD、TAS-POST、Tmsv-l6-SD和Tmsv-16-Dif。结果与正常对照组比较,心肌缺血组常规超声心动图无阳性发现,2D-STI示GLS明显降低,Tls-16-SD明显延长(P<0.05);RT-3DE“牛眼图”可见室壁运动异常的节段,Tmsv-16-SD、Tmsv-16-Dif明显延长(P<0.05)。心肌梗死组常规超声心动图、2D-STI及RT-3DE均有阳性表现,RT-3DE与2D-STI同步性参数相关性分析示Tmsv-16-SD与TAS-POST呈正相关(r=0.574,P<0.01),其余参数无相关性。结论 RT-3DE与2D-STI可早期客观评价心肌缺血组冠心病患者左室收缩同步性,且二者存在一定相关性。
Objective To investigate the clinical value of real-time three-dimensional echocardiography (RT-3DE) and two-dimensional speckle tracking imaging (2D-STI) in evaluating left ventricular global systolic function and synchrony in patients with myocardial ischemia and myocardial infarction Evaluate the correlation of left ventricular systolic synchrony. Methods RT-3DE and 2D-STI were performed in 46 cases of myocardial ischemia (myocardial ischemia group), 44 cases of myocardial infarction (myocardial infarction group) and 60 healthy volunteers (normal control group). Qlab8.1 software Off-line analysis of left ventricular systolic function parameters: GLS, GCS, GRS, 3D-LVEDV, 3D-LVESV and 3D-LVEF; synchronization parameters: Tls-l6-SD, Trs-l2- SD, Tcs-l2-SD , TAS-POST, Tmsv-l6-SD and Tmsv-16-Dif. Results Compared with the normal control group, the conventional echocardiography was not found in the myocardial ischemia group. The GLS of 2D-STI was significantly decreased and Tls-16-SD was significantly prolonged (P <0.05) Visible segment wall abnormalities segments, Tmsv-16-SD, Tmsv-16-Dif significantly prolonged (P <0.05). The correlation between RT-3DE and 2D-STI synchronicity parameters showed that Tmsv-16-SD was positively correlated with TAS-POST (r = 0.574, P <0.01), the other parameters no correlation. Conclusion RT-3DE and 2D-STI can be an objective early evaluation of myocardial ischemia in patients with coronary heart disease in patients with left ventricular systolic synchrony, and there is a certain correlation between the two.