Rafieyian Sima, Roodpeyma Shahla, Vahidshahi Kourosh, Moghadasi Alireza
Shahid Modarres Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
J Tehran Heart Cent. 2018 Jan;13(1):18-23.
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.
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。
