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左心室心肌致密化不全患儿左心室心肌变形的收缩-舒张耦合

Systolic-diastolic coupling of myocardial deformation of the left ventricle in children with left ventricular noncompaction.

作者信息

Koh C, Hong W J, Wong S J, Cheung Y F

机构信息

Division of Paediatric Cardiology, Department of Paediatrics and Adolescent Medicine, Queen Mary Hospital, The University of Hong Kong, 102 Pokfulam Road, Hong Kong, China.

出版信息

Heart Vessels. 2010 Nov;25(6):493-9. doi: 10.1007/s00380-010-0001-8. Epub 2010 Sep 28.

Abstract

Disruption of the myocardial architecture in left ventricular noncompaction (LVNC) may alter myocardial deformation. We evaluated LV myocardial deformation and tested the hypothesis that tight systolic-diastolic coupling occurs in LVNC. Longitudinal and circumferential strain and strain rates (SRs) as determined by speckle tracking echocardiography in nine children aged 5.6 ± 5.5 years was compared with those in nine controls. Left ventricular systolic myocardial deformation parameters were correlated with ejection fraction and indices of diastolic deformation. Compared with controls, patients had lower global LV systolic longitudinal strain (P = 0.008), systolic SR (P = 0.05) and early diastolic SR (P < 0.001). Similarly, LV systolic circumferential strain (base, P = 0.04; papillary muscle level, P = 0.01; apex, P = 0.04), systolic SR (base, P = 0.04) and early diastolic SR (papillary muscle level, P = 0.004, apex, P = 0.02) were lower in patients than in controls. Among patients, the LV ejection fraction correlated with global longitudinal systolic strain and SR and circumferential systolic strain and SR at all levels (all P < 0.05). Positive correlations existed between early diastolic and systolic SRs in corresponding dimensions (longitudinal r = 0.80, P = 0.01; circumferential at base, r = 0.91, P = 0.001; papillary muscle level, r = 0.96, P < 0.001; apex r = 0.98, P = <0.001). In conclusion, LV myocardial deformation is reduced in the longitudinal and circumferential dimensions and manifests tight systolic-diastolic coupling in children with LVNC.

摘要

左心室心肌致密化不全(LVNC)中心肌结构的破坏可能会改变心肌变形。我们评估了左心室心肌变形,并验证了LVNC中存在紧密的收缩-舒张耦合这一假设。通过斑点追踪超声心动图测定了9名年龄为5.6±5.5岁儿童的纵向和圆周应变及应变率(SRs),并与9名对照组儿童进行了比较。左心室收缩期心肌变形参数与射血分数及舒张期变形指标相关。与对照组相比,患者的左心室整体收缩期纵向应变较低(P = 0.008)、收缩期SR较低(P = 0.05)以及舒张早期SR较低(P < 0.001)。同样,患者的左心室收缩期圆周应变(基部,P = 0.04;乳头肌水平,P = 0.01;心尖,P = 0.04)、收缩期SR(基部,P = 0.04)以及舒张早期SR(乳头肌水平,P = 0.004,心尖,P = 0.02)均低于对照组。在患者中,左心室射血分数与所有水平的整体纵向收缩期应变和SR以及圆周收缩期应变和SR均相关(所有P < 0.05)。在相应维度中,舒张早期和收缩期SR之间存在正相关(纵向r = 0.80,P = 0.01;基部圆周,r = 0.91,P = 0.001;乳头肌水平,r = 0.96,P < 0.001;心尖r = 0.98,P = <0.001)。总之,LVNC患儿的左心室心肌在纵向和圆周维度上变形减少,并表现出紧密的收缩-舒张耦合。

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