二维斑点跟踪评估肥厚性心肌病患儿心肌应变

N. Chernykh, A. Tarasova, O. Groznova
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摘要

目的:探讨儿童肥厚性心肌病(HCM)的心肌应变。方法:61例7 ~ 17岁非对称型HCM患者采用标准技术进行心脏超声检查。采用二维(2D)斑点跟踪模式对左心室收缩功能进行评估,分析参数包括整体和节段的纵向、圆周和径向心肌应变。确定了左心室各节段心内膜下层和心外膜下层的应变数据及其总价值。结果:非梗阻性和梗阻性HCM均因肥厚心肌节段收缩性受损而导致整体纵应变和纵应变率降低。在所有梗阻性HCM患儿和39例(86.6%)非梗阻性HCM患儿中,均观察到整体、径向和周向应变参数及其发生率下降。同时,非梗阻性HCM患儿的菌株和菌株率与梗阻性HCM患儿相比有统计学上的显著差异。结论:利用二维斑点追踪模式观察HCM患儿心肌应变变化提示早期左心室收缩功能障碍。纵向应变相对于径向和周向应变最为敏感。梗阻性HCM患儿与非梗阻性HCM患儿的差异有统计学意义。这些结果对于早期开始治疗很重要,因此可能改善HCM患儿的预后。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
2D speckle-tracking in assessment of myocardial strain in children with hypertrophic cardiomyopathy
Purpose: To assess the myocardial strain in children with hypertrophic cardiomyopathy (HCM). Methods: A total of 61 patients aged between 7 and 17 years with an asymmetric form of HCM underwent an ultrasound examination of the heart using standard techniques. An assessment of the left ventricular systolic function was performed using the two-dimensional (2D) speckle-tracking mode with analysis parameters that included global and segmental longitudinal, circumferential, and radial myocardial strains. Strain data for the subendocardial and subepicardial layers for each segment of the left ventricle, as well as their total values, were determined. Results: Global longitudinal strain and longitudinal strain rate were dec reased due to the impaired contractility of hypertrophied myocardial segments in 100% of cases of non-obstructive and obstructive HCM forms. A decrease in global, radial, and circumferential strain parameters and their rates has been observed in all children with an obstructive form of HCM and 39 (86.6%) patients with non-obstructive form. At the same time, there was a statistically significant difference between strains and strain rates in children with a non-obstructive form of HCM in comparison to those with an obstructive form of the disease. Conclusion: Changes in myocardial strains observed using the 2D speckle-tracking mode in children with HCM indicate early systolic dysfunction of the left ventricle. Longitudinal strain was the most sensitive compared to radial and circumferential types. It was statistically significantly different in children with an obstructive form of HCM compared to those with non-obstructive form of the disease. These results are important for early therapy initiation and, therefore, may improve prognosis in children with HCM.
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