[应用斑点追踪成像技术评估糖尿病心血管自主神经病变患者的左心室功能及扭转运动]

[Evaluation of left ventricular function and twist in patients with diabetic cardiovascular autonomic neuropathy by speckle tracking imaging].

作者信息

Liu Xiao-yu, Dai Min, Zheng Jie, Zhang Chang-ying, Li Ku-lin, Gao Yun-lai, Li Xiao-yan, Tang Yuan-yuan, Qian Da-jun, Wang Ru-xing

机构信息

Nanjing Medical University, Wuxi, China.

出版信息

Zhonghua Xin Xue Guan Bing Za Zhi. 2012 Feb;40(2):147-52.

PMID:22490716

Abstract

OBJECTIVE

To evaluate left ventricular (LV) function and twist in patients with diabetic cardiovascular autonomic neuropathy (CAN) by two-dimensional speckle tracking imaging (STI).

METHODS

STI was performed in 56 subjects with type 2 diabetes mellitus (DM) (35 with DM only: group A, 21 with CAN: group B) and 34 normal subjects (Control) from LV short-axis view. LV peak systolic, peak early (E') and peak late (A') diastolic circumferential strain in 18 myocardial segments were measured at the levels of mitral annulus, papillary muscle and apex and the rotation at mitral annulus and apex levels were also measured. LV peak systolic and the ratio of E' and A' of global and three levels, twist, untwisting rate and untwisting half-time were calculated.

RESULTS

In group A, compared with control group, LV peak systolic radial circumferential strain has no significant difference (P > 0.05), E'/A' was reduced (P < 0.05), twist at aortic valve closure and twist at mitral valve opening were significantly increased (P < 0.05), untwisting rate reduced, and untwisting half time delayed. In group B, compared with control group and group A, circumferential strain parameters [(-12.64 ± 6.49)% vs. (-19.11 ± 9.98)% and (-21.14 ± 10.13)%, P < 0.05] and E'/A' [(0.90 ± 0.35) vs. (1.24 ± 0.47) and (1.98 ± 0.63), P < 0.05] were significantly decreased, twist at aortic valve closure [(19.08 ± 5.62)° vs. (16.57 ± 2.84)° and (14.36 ± 4.06)°, P < 0.05] and twist at mitral valve opening [(13.99 ± 2.31)° vs. (11.36 ± 2.63)° and (9.04 ± 5.63)°, P < 0.05] were significantly increased, untwisting rate [(0.40 ± 0.28)%/ms vs. (0.46 ± 0.14)%/ms and (0.53 ± 0.21)%/ms, P < 0.05] reduced, and untwisting half time [(489.61 ± 97.14) ms vs. (445.21 ± 54.53) ms and (410.60 ± 50.23) ms, P < 0.05] delayed.

CONCLUSION

Speckle tracking imaging could be used to evaluate early changes on LV twist deformation and LV systolic function in patients with type 2 diabetes mellitus.

摘要

目的

采用二维斑点追踪成像（STI）评估糖尿病性心血管自主神经病变（CAN）患者的左心室（LV）功能和扭转情况。

方法

对56例2型糖尿病（DM）患者（35例单纯DM：A组，21例合并CAN：B组）和34例正常受试者（对照组）进行LV短轴观STI检查。在二尖瓣环、乳头肌和心尖水平测量18个心肌节段的LV收缩期峰值、舒张早期峰值（E'）和舒张晚期峰值（A'）圆周应变，并测量二尖瓣环和心尖水平的旋转情况。计算LV收缩期峰值以及整体和三个水平的E'与A'比值、扭转、解旋速率和解旋半衰期。

结果

A组与对照组相比，LV收缩期峰值径向圆周应变无显著差异（P>0.05），E'/A'降低（P<0.05），主动脉瓣关闭时的扭转和二尖瓣开放时的扭转显著增加（P<0.05），解旋速率降低，解旋半衰期延迟。B组与对照组和A组相比，圆周应变参数[（-12.64±6.49）%对（-19.11±9.98）%和（-21.14±10.13）%，P<0.05]和E'/A'[（0.90±0.35）对（1.24±0.47）和（1.98±0.63），P<0.05]显著降低，主动脉瓣关闭时的扭转[（19.08±5.62）°对（16.57±2.84）°和（14.36±4.06）°，P<0.05]和二尖瓣开放时的扭转[（13.99±2.31）°对（11.36±2.63）°和（9.04±5.63）°，P<0.05]显著增加，解旋速率[（0.40±0.28）%/ms对（0.46±0.14）%/ms和（0.53±0.21）%/ms，P<0.05]降低，解旋半衰期[（489.61±97.14）ms对（445.21±54.53）ms和（410.60±50.23）ms，P<0.05]延迟。