Assessment of left ventricular systolic and diastolic abnormalities in patients with hypertrophic cardiomyopathy using real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging.
Assessment of left ventricular systolic and diastolic abnormalities in patients with hypertrophic cardiomyopathy using real-time three-dimensional echocardiography and two-dimensional speckle tracking imaging.
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DOI：
10.1186/s12947-018-0142-y
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发表时间：
2018-10-02
影响因子：
1.9
通讯作者：
Cao J
中科院分区：
文献类型：
--
作者：
Huang X;Yue Y;Wang Y;Deng Y;Liu L;Di Y;Sun S;Chen D;Fan L;Cao J
传统超声心动图不够灵敏，无法评估肥厚型心肌病 (HCM) 患者的左心室 (LV) 功能障碍。本研究试图寻找一种新的超声技术来更好地评估HCM患者的左心室舒张功能、收缩功能以及不同厚度节段的心肌纵向和周向收缩应变。这项研究包括 50 名 HCM 患者和 40 名健康受试者作为对照。使用实时三平面超声心动图和定量组织速度成像 (RT-3PE-QTVI) 测量六个位点的早期和晚期二尖瓣环舒张期峰值速度（分别为 Ea' 和 Aa'）以及 Ea'/Aa' 比值。获得六个位点的 Ea' 平均值（Em'），用于计算 E/Em' 比值。使用实时三维超声心动图（RT-3DE）测量左心室舒张末期容积（LVEDV）、左心室收缩末期容积（LVESV）、左心室每搏输出量（LVSV）和左心室射血分数（LVEF）。使用二维散斑跟踪成像（2D-STI）软件获得心尖-中-基底节段（分别为 LPSS-api、LPSS-mid、LPSS-bas；CPSS-api、CPSS-mid 和 CPSS-bas）的左心室心肌纵向峰值收缩应变（LPSS）和周向峰值收缩应变（CPSS）。根据每位HCM患者不同的节段厚度（ST），将所有心肌节段的值（LPSS和CPSS）分为三组，并计算各自的平均值。 HCM 患者的 Ea'、Aa' 和 Ea'/Aa' 比值均低于对照组（均 p<0.001），而 HCM 患者的 E/Em' 比值高于对照组（p<0.001）。 HCM 患者的 LVEDV、LVSV 和 LVEF 显着低于对照组（均 p<0.001）。在 HCM 患者中，LPSS-api、LPSS-mid、LPSS-bas、CPSS-api、CPSS-mid 和 CPSS-bas 以及不同厚度 LV 节段的 LPSS 和 CPSS 均显着降低（均 p<0.001）。 HCM患者心肌功能障碍不仅在明显肥厚的节段广泛存在，而且在非肥厚的节段也普遍存在；即使 LVEF 正常，左心室收缩和舒张功能也会受损。 RT-3PE-QTVI、RT-3DE和2D-STI可以敏感地揭示HCM患者的左室舒张功能障碍、收缩功能障碍和心肌变形损伤。
Conventional echocardiography is not sensitive enough to assess left ventricular (LV) dysfunction in hypertrophic cardiomyopathy (HCM) patients. This research attempts to find a new ultrasonic technology to better assess LV diastolic function, systolic function, and myocardial longitudinal and circumferential systolic strain of segments with different thicknesses in HCM patients. This study included 50 patients with HCM and 40 healthy subjects as controls. The peak early and late mitral annulus diastolic velocities at six loci (Ea′ and Aa′, respectively) and the Ea′/Aa′ ratio were measured using real-time tri-plane echocardiography and quantitative tissue velocity imaging (RT-3PE-QTVI). The mean value of Ea′ at six loci (Em′) was obtained for the calculation of E/Em′ ratio. The LV end-diastolic volume (LVEDV), LV end-systolic volume (LVESV), LV stroke volume (LVSV), and LV ejection fraction (LVEF) were measured using real-time three-dimensional echocardiography (RT-3DE). LV myocardial longitudinal peak systolic strain (LPSS) and circumferential peak systolic strain (CPSS) in the apical-middle-basal segments (LPSS-api, LPSS-mid, LPSS-bas; CPSS-api, CPSS-mid, and CPSS-bas, respectively) were obtained using a software for two-dimensional speckle tracking imaging (2D-STI). According to the different segmental thicknesses (STs) in each HCM patient, the values (LPSS and CPSS) of all the myocardial segments were categorized into three groups and the respective averages were computed. The Ea′, Aa′, and, Ea′/Aa’ ratio in HCM patients were lower than those in the controls (all p < 0.001), while the E/Em′ ratio in HCM patients was higher than that in the controls (p < 0.001). The LVEDV, LVSV, and LVEF were significantly lower in HCM patients than in controls (all p < 0.001). In HCM patients, the LPSS-api, LPSS-mid, LPSS-bas, CPSS-api, CPSS-mid, and CPSS-bas and the LPSS and CPSS of LV segments with different thicknesses were all significantly reduced (all p < 0.001). In HCM patients, myocardial dysfunction was widespread not only in the obviously hypertrophic segments but also in the non-hypertrophic segments; the LV systolic and diastolic functions were damaged, even with a normal LVEF. LV diastolic dysfunction, systolic dysfunction, and myocardial deformation impairment in HCM patients can be sensitively revealed by RT-3PE-QTVI, RT-3DE, and 2D-STI.
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影响因子：
168.9
作者：
Marian, AJ
通讯作者：
Marian, AJ
影响因子：
2.1
作者：
Zhang, Hong-Ju;Wang, Hao;Lin, Qiong-Wen
通讯作者：
Lin, Qiong-Wen
DOI：
10.1186/s12968-016-0223-8
发表时间：
2016-01-14
期刊：
Journal of cardiovascular magnetic resonance : official journal of the Society for Cardiovascular Magnetic Resonance
影响因子：
--
作者：
Villa AD;Sammut E;Zarinabad N;Carr-White G;Lee J;Bettencourt N;Razavi R;Nagel E;Chiribiri A
通讯作者：
Chiribiri A
肥厚型心肌病患者左心室纵向整体和节段收缩功能的降低：二维组织运动环形位移的研究
影响因子：
2.7
作者：
Liu L;Tuo S;Zhang J;Zuo L;Liu F;Hao L;Sun Y;Yang L;Shao H;Qi W;Zhou X;Ge S
通讯作者：
Ge S
影响因子：
1.9
作者：
Kao, Yu-Cheng;Lee, Ming-Feng;Hung, Ming-Jui
通讯作者：
Hung, Ming-Jui