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非缺血性扩张型心肌病中超声组织特征与心肌变形之间的关系对左心室逆向重构的预测作用

Relationship between ultrasonic tissue characterization and myocardial deformation for prediction of left ventricular reverse remodelling in non-ischaemic dilated cardiomyopathy.

作者信息

Park Seong-Mi, Kim Yong-Hyun, Ahn Chul-Min, Hong Soon-Jun, Lim Do-Sun, Shim Wan-Joo

机构信息

Division of Cardiology, Department of Internal Medicine, Korea University College of Medicine, 126-1, Anam-dong 5 ga, Seongbuk-gu, Seoul 136-705, Republic of Korea.

出版信息

Eur J Echocardiogr. 2011 Dec;12(12):887-94. doi: 10.1093/ejechocard/jer177. Epub 2011 Sep 20.

Abstract

AIMS

This study was to evaluate the relationship between ultrasonic tissue characterization by integrated backscatter (IBS) and myocardial deformation assessed by two-dimensional speckled tracking (2DS) imaging for prediction of left ventricular (LV) reverse remodelling in patients with non-ischaemic dilated cardiomyopathy (DCM).

METHODS AND RESULTS

Forty-five consecutive patients with non-ischaemic DCM were enrolled prospectively. The mean cyclic variation of integrated backscatter (CVIBS) was calculated as the mean of the septal and posterior wall CVIBS. LV global longitudinal, radial, and circumferential peak strain (GLS, GRS, and GCS, respectively) and twist were obtained. LV reverse remodelling was decided with follow-up echocardiography 12 months. The GLS, GRS, and GCS were correlated with the mean CVIBS. The mean CVIBS and GCS were significantly larger in the 24 patients who had LV reverse remodelling than the 21 patients who had no LV reverse remodelling and the GRS tended to be larger; the GLS and twist did not differ between the two groups. The mean CVIBS and GCS were independent predictors of LV reverse remodelling.

CONCLUSION

Myocardial deformation assessed by 2DS was related to myocardial fibrosis assessed by IBS. LV reverse remodelling was predicted by mean CVIBS and GCS in patients with non-ischaemic DCM and GCS assessed by 2DS imaging is a simple method and therefore it can be readily used in clinical practice.

摘要

目的

本研究旨在评估非缺血性扩张型心肌病(DCM)患者中,基于背向散射积分(IBS)的超声组织特征与通过二维斑点追踪(2DS)成像评估的心肌变形之间的关系,以预测左心室(LV)逆向重构。

方法与结果

前瞻性纳入45例连续的非缺血性DCM患者。计算背向散射积分的平均周期变化(CVIBS),即室间隔和后壁CVIBS的平均值。获得左心室整体纵向、径向和圆周方向的峰值应变(分别为GLS、GRS和GCS)以及扭转。通过12个月的随访超声心动图确定左心室逆向重构情况。GLS、GRS和GCS与平均CVIBS相关。在发生左心室逆向重构的24例患者中,平均CVIBS和GCS显著大于未发生左心室逆向重构的21例患者,GRS也有增大趋势;两组之间GLS和扭转无差异。平均CVIBS和GCS是左心室逆向重构的独立预测因素。

结论

2DS评估的心肌变形与IBS评估的心肌纤维化相关。非缺血性DCM患者中,平均CVIBS和GCS可预测左心室逆向重构,且通过2DS成像评估的GCS是一种简单方法,因此可在临床实践中方便地应用。

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