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目的运用斑点追踪技术比较扩张型心肌病患者与正常人群主动脉瓣环和二尖瓣环位移(AE)及主动脉瓣二尖瓣环平面夹角(AMA)的大小及变化规律;评价二者间的偶联机制并探讨瓣环偶联运动与左室功能的相关性。方法纳入35例扩张型心肌病患者及35例性别年龄相匹配的健康人作为对照,采集经胸超声心动图图像。在胸骨旁长轴切面,使用Philips QLAB 9.0软件对瓣环各点AE及AMA进行二维定量。在心尖四腔心切面,使用Tomtec Arene1.0三维软件获取左室射血分数(LVEF)及整体纵向、环向及径向应变参数。结果与正常对照相比,扩张型心肌病患者各瓣环处AE明显减小,AMAmax及AMAmin增大,AMAmax-min减小,差异有统计学意义,其AE及AMA在心动周期内的变化规律与正常对照略有差异,即AMA在舒张期较早地达到最大值且变化幅度减小。各AE均与LVEF及各向应变正性相关,AMAmax及AMAmin与各AE、LVEF及各向应变负性相关,AMAmax-min与各AE、LVEF及各向应变正性相关(P均<0.05)。结论斑点追踪技术可用于快速方便地定量AE、AMA、LVEF及各向应变。扩张型心肌病患者主动脉瓣环和二尖瓣环的偶联运动存在异常,与左室收缩功能密切相关。瓣环位移及夹角可较方便、快速地判断心脏整体及局部收缩功能。
OBJECTIVE: To compare the changes of the aortic valve annulus and mitral annular displacement (A A) and the aortic valve mitral annulus angle (AMA) between dilated cardiomyopathy patients and normal subjects by speckle tracking technique. Between the coupling mechanism and explore the valve ring coupling movement and left ventricular function correlation. Methods Thirty-five patients with dilated cardiomyopathy and 35 healthy individuals of the same gender were enrolled as the control, and transthoracic echocardiographic images were collected. At the parasternal long-axis view, the annulus AE and AMA were two-dimensionally quantified using Philips QLAB 9.0 software. In the apical four-chamber view, left ventricular ejection fraction (LVEF) and global longitudinal, circumferential and radial strain parameters were obtained using Tomtec Arene 1.0 3D software. Results Compared with the control group, the values of AE in each cochlear ring of patients with dilated cardiomyopathy were significantly decreased, AMAmax and AMAmin were increased, AMAmax-min was decreased, the difference was statistically significant, the changes of AE and AMA in the cardiac cycle There is a slight difference with the normal control, that is, AMA reaches its maximum at diastole and decreases in amplitude. Each AE was positively correlated with LVEF and all-direction strain, AMAmax and AMAmin were negatively correlated with each AE, LVEF and all-direction strain, and AMAmax-min was positively correlated with each AE, LVEF and all-direction strain (P all <0.05) . Conclusions Speckle tracking techniques can be used to quickly and easily quantify AE, AMA, LVEF, and strain in all directions. Dilated cardiomyopathy in patients with aortic valve annulus and mitral annulus coupling movement abnormalities, and left ventricular systolic function are closely related. Annular displacement and the angle can be more convenient and fast to determine the overall and local systolic function.