Dogan Vehbi, Öcal Burhan, Orun Utku Arman, Ozgur Senem, Yılmaz Osman, Keskin Mahmut, Ceylan Ozben, Karademir Selmin, Şenocak Filiz
Department of Pediatric Cardiology, Faculty of Medicine, Gaziosmanpaşa University, Tokat, Turkey.
Pediatr Cardiol. 2013 Jun;34(5):1152-8. doi: 10.1007/s00246-012-0619-7. Epub 2013 Jan 12.
The aim of our study was to evaluate myocardial functions with strain/strain rate echocardiography in asymptomatic patients having congenital aortic stenosis (CAS) with normal cardiac functions as determined by conventional echocardiographic techniques and comparing them with those of healthy controls. A total of 58 patients with various degrees of isolated CAS and 52 healthy controls were enrolled in this study. Conventional and two-dimensional speckle tracking (2DSTE) echocardiography were performed. Global longitudinal strain (LS) (-23.1 ± 3.6 and -23.8 ± 4.7), and longitudinal strain rate (LSR) (-1.49 ± 0.32 and -1.76 ± 0.39) values were lower, whereas circumferential strain (CS) (-25.9 ± 4.7 and -22.8 ± 6.4) and circumferential strain rate (CSR) (-1.82 ± 0.46 and -1.69 ± 0.49) values were greater in the patient group than in the control subjects. The difference was significant for global LSR and CS (p < 0.05) values. Regional analysis showed lower LS values in the basal part of the left-ventricular (LV) free wall and lower LSR values in the basal parts of both of the septum and free wall in the patient group (p < 0.05). CS values in the anteroseptal, posterior, and inferior walls were significantly greater in the patients (p < 0.05). 2DSTE detects subtle alterations in myocardial function in asymptomatic children with CAS. Impairment of LV long-axis function occurred earlier and was more prominent in basal parts of the interventricular septum and the free wall of the left ventricle.
我们研究的目的是,采用应变/应变率超声心动图评估无症状先天性主动脉狭窄(CAS)患者的心肌功能,这些患者的心脏功能通过传统超声心动图技术测定为正常,并与健康对照者进行比较。本研究共纳入58例不同程度的孤立性CAS患者和52例健康对照者。进行了传统及二维斑点追踪(2DSTE)超声心动图检查。患者组的整体纵向应变(LS)(-23.1±3.6和-23.8±4.7)及纵向应变率(LSR)(-1.49±0.32和-1.76±0.39)值较低,而圆周应变(CS)(-25.9±4.7和-22.8±6.4)及圆周应变率(CSR)(-1.82±0.46和-1.69±0.49)值高于对照组。整体LSR和CS值的差异具有统计学意义(p<0.05)。区域分析显示,患者组左心室(LV)游离壁基底段的LS值较低,室间隔和游离壁基底段的LSR值较低(p<0.05)。患者前间隔、后壁和下壁的CS值显著更高(p<0.05)。2DSTE可检测无症状CAS儿童心肌功能的细微改变。左心室长轴功能损害更早出现,且在室间隔基底段和左心室游离壁更为明显。