心肌运动与心肌纤维排列方向关系的超声研究

心肌纤维排列方向紊乱是某些心肌疾病的主要特征性病理表现，其排列紊乱程度与心脏功能及患者预后密切相关。因此，研究心肌纤维排列方向对疾病的早期诊断、预后判断以及阐明疾病的病理生理机制有重要的意义。我们将在肥厚型心肌病动物模型和患者中，通过实时三维超声斑点追踪技术测量心脏左心室心肌节段在各个方向上的应变并由此计算左室心肌节段总应变矢量与各平面间的角度，以确定心肌节段在三维立体空间中的真实运动方向。将斑点追踪技术所获得结果与病理学及磁共振成像所获取的有关心肌纤维排列方向的结果进行比较分析，探讨心肌总应变矢量方向与心肌纤维排列方向的关系，这在国内外尚无同类报道。本研究将为应用实时三维超声斑点追踪技术检测心肌纤维排列方向提供实验依据，具有潜在的临床应用价值。

Myocardial fiber disarray has been considered to be a principal and characteristic pathological feature in many myocardial diseases. The myocardial fiber disarray is correlated with cardiac function and prognosis of patients. Therefore, a research into myocardial fiber orientation will be of significant value for early diagnosis and prognosis prediction of related diseases, and will also help us to understand their pathophysiological mechanism. We will measure strains of every left ventricular segment by real-time three-dimensional speckle tracking echocardiography in animal models and patients with hypertrophic cardiomyopathy, then calculate the angles between main strain vector and every standard plane for each myocardial segment, this will permit us to identify the real movement direction of the myocardial segment in three-dimensional space. Myocardial fiber orientation will be studied by pathological examination and MRI, and compared with the results acquired by three-dimensional speckle tracking echocardiography, thus evaluate the correlation of myocardial main strain vector direction and myocardial fiber orientation, to which no similar research has been reported before. Our research will provide experimental evident for evaluation of myocardial fiber orientation by real-time three-dimensional speckle tracking echocardiography, and has potential value for clinical application.