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先天性心脏畸形手术修复前后通过应变和应变率评估局部心肌功能

Evaluation of Regional Myocardial Function by Strain and Strain Rate before and after Surgical Repair of Congenital Heart Anomalies.

作者信息

Rafieyian Sima, Roodpeyma Shahla, Vahidshahi Kourosh, Moghadasi Alireza

机构信息

Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.

出版信息

J Tehran Heart Cent. 2018 Jan;13(1):18-23.

Abstract

Tissue Doppler imaging yields useful information about regional myocardial function. The purpose of this study was to investigate myocardial function by strain and strain rate in a group of patients with congenital heart disease (CHD) before and after cardiac surgery. Three consecutive tissue Doppler echocardiographic examinations were performed on 25 patients with CHD, who underwent open-heart surgery. The study was conducted from April 2013 to April 2014 in a university hospital, and the assessments were done 1 day before and 1 week and 1 month after surgery. The effects of demographic variables, types of anomalies, and cardiopulmonary bypass factors on strain were evaluated. The study population comprised 13 female and 12 male patients at a mean age of 9.4 ± 9.8 years. Compared to the preoperative data, repeated measurements of strain in 9 segments of the ventricles showed a significant reduction 1 week after surgery, followed by a significant augmentation 1 month postoperatively (p value = 0.001 for all 9 segments). The reduction in strain at the middle segment of the left ventricular free wall was significant in the cyanotic patients (p value = 0.037). The increase in strain at the middle segment of the septum and the right ventricular basal and middle segments was significant (p value = 0.021, p value = 0.015, and p value = 0.021, respectively) in the patients with a shorter pump time. Our patients experienced an early decline in myocardial function after cardiac surgery, but their myocardium recovered its contractility gradually.

摘要

组织多普勒成像可提供有关局部心肌功能的有用信息。本研究的目的是通过应变和应变率来调查一组先天性心脏病(CHD)患者在心脏手术后心肌功能的情况。对25例接受心脏直视手术的CHD患者进行了连续三次组织多普勒超声心动图检查。该研究于2013年4月至2014年4月在一家大学医院进行,评估在手术前1天以及手术后1周和1个月进行。评估了人口统计学变量、异常类型和体外循环因素对应变的影响。研究人群包括13名女性和12名男性患者,平均年龄为9.4±9.8岁。与术前数据相比,对心室9个节段的应变进行重复测量显示,术后1周应变显著降低,随后在术后1个月显著增加(所有9个节段的p值均为0.001)。青紫型患者左心室游离壁中间节段的应变降低显著(p值=0.037)。在体外循环时间较短的患者中,室间隔中间节段以及右心室基底和中间节段的应变增加显著(分别为p值=0.021、p值=0.015和p值=0.021)。我们的患者在心脏手术后心肌功能早期下降,但心肌收缩力逐渐恢复。

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