Orii Makoto, Hirata Kumiko, Tanimoto Takashi, Shiono Yasutsugu, Shimamura Kunihiro, Yamano Takashi, Ino Yasushi, Yamaguchi Tomoyuki, Kubo Takashi, Tanaka Atsushi, Imanishi Toshio, Akasaka Takashi
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
Department of Cardiovascular Medicine, Wakayama Medical University, Wakayama, Japan.
J Am Soc Echocardiogr. 2015 Jun;28(6):683-91. doi: 10.1016/j.echo.2015.02.018. Epub 2015 Mar 30.
The aim of this study was to determine whether two-dimensional speckle-tracking echocardiography can identify the myocardial damage detected by delayed enhancement (DE) magnetic resonance imaging via the differences in myocardial deformation in patients with extracardiac sarcoidosis who showed no structural and functional abnormalities in the heart.
Forty-five patients with biopsy-proven extracardiac sarcoidosis were analyzed retrospectively. Patients with abnormal electrocardiographic and echocardiographic findings, including ventricular arrhythmias, heart block, regional wall motion abnormalities, valvular heart disease, and cardiomyopathy, were excluded. Ten age-matched healthy control subjects were recruited as a control group. Comprehensive echocardiography and DE magnetic resonance imaging were performed, and circumferential, longitudinal, and radial strain were consecutively assessed using two-dimensional speckle-tracking echocardiographic software in a 16-segment model of the left ventricle in accordance to the presence (DE+) or absence (DE-) of DE.
Among the 45 patients, 36 segments in 13 patients showed DE. DE+ segments had lower peak circumferential strain than DE- and control segments (-14 ± 5% vs -28 ± 7% vs -30 ± 7%, P < .0001). Peak longitudinal strain in DE+ segments was significantly decreased compared with control segments (-19 ± 4% vs -23 ± 5%, P = .005). However, peak radial strain was similar among the three groups: 41 ± 17% in DE+ segments, 45 ± 23% in DE- segments, and 46 ± 18% in control segments (P = .50).
Circumferential and longitudinal strain via two-dimensional speckle-tracking echocardiography can identify the myocardial damage detected by DE magnetic resonance imaging in patients with extracardiac sarcoidosis.
本研究旨在确定二维斑点追踪超声心动图能否通过心脏无结构和功能异常的心脏外结节病患者心肌变形的差异，识别延迟强化（DE）磁共振成像检测到的心肌损伤。
对45例经活检证实的心脏外结节病患者进行回顾性分析。排除心电图和超声心动图检查结果异常的患者，包括室性心律失常、心脏传导阻滞、局部室壁运动异常、心脏瓣膜病和心肌病。招募10名年龄匹配的健康对照者作为对照组。进行了全面的超声心动图和DE磁共振成像检查，并根据是否存在DE，使用二维斑点追踪超声心动图软件在左心室的16节段模型中连续评估圆周应变、纵向应变和径向应变。
45例患者中，13例患者的36个节段显示有DE。DE+节段的峰值圆周应变低于DE-节段和对照节段（-14±5% 对 -28±7% 对 -30±7%，P <.0001）。与对照节段相比，DE+节段的峰值纵向应变显著降低（-19±4% 对 -23±5%，P =.005）。然而，三组之间的峰值径向应变相似：DE+节段为41±17%，DE-节段为45±23%，对照节段为46±18%（P =.50）。
通过二维斑点追踪超声心动图测量的圆周应变和纵向应变能够识别心脏外结节病患者中DE磁共振成像检测到的心肌损伤。
