中文摘要：

目的 应用超声速度向量成像（velocity vector imaging,VVI）技术评价心电图胸前导联T波倒置患者左心室不同步状态,为明确缺血性心脏病临床诊断和治疗提供更为深入可靠的量化评价和疗效观察指标.方法 心电图胸前导联T波倒置女性患者共计113例,分为三个试验组：V1～6T波倒置组（A组）50例、V1～4T波倒置组（B组）31例、V3～6T波倒置组（C组）32例;另外选取对照组40例.采集三个心动周期标准左心室短轴二尖辩、乳头肌、心尖水平切面二维灰阶动态图像;应用VVI成像软件对图像分析处理并获得左心室短轴三个水平共18个节段的收缩期径向应变达峰时间（PTrs）、周向应变达峰时间（PTcs）.计算左室18个节段PTrs、PTcs的标准差（PTrs-SD、PTcs-SD）.结果 各试验组左室心肌收缩不同步指标（PTrs-SD、PTcs-SD）与对照组相比均增大,差异均具有统计学意义（P＜0.01）;与对照组相比,V1～6T波倒置组中前壁（基底段、中间段）、前间隔（基底段、中间段）及前侧壁（基底段）PTrs、前间隔（中间段）PTcs、后间隔（中间段）PTcs均发生了延迟,差异具有统计学意义（P=0.00～002）;V1～4T波倒置组中的前间隔（中间段）与V3～6T波倒置组中前侧壁（心尖段）的PTrs均发生了延迟,差异具有统计学意义（P=0.02～0.03）.各试验组周向及径向应变峰值时间顺序均大致按顺时针和逆时针两个方向,V1～6T波倒置组与V1～4T波倒置组PTrs与PTcs的起源均为后壁,最后到达前间隔;而V3～6T波倒置组PTrs与PTcs的起源均为前壁,最后到达分别为后间隔、前侧壁.对照组峰值顺序以顺时针方向为主,起点为前壁,最后到达后间隔.结论 心电图胸前导联T波倒置女性患者左心室收缩不同步,其周径向应变达峰时间顺序与对照组不一致;电活动异常范围可间接反映机械运动不同步范围.

英文摘要：

Objective To evaluate dyssynchrony of left ventricle in patients with ECG T-wave inversion in different precordial leads using echocardiographic velocity vector imaging.To provide more reliable and in-depth quantitative evaluation and efficacy indicators for precise diagnosis and treatment of ischemic heart disease.Methods One hundred thirteen female patients with T-wave inversion divided into three groups：V1-6 T-wave inversion group （50 patients）,V1-4 Twave inversion group （31 patients）,V3-6 T-wave inversion group （32patients）,while selected 40 healthy women in control group.The dynamic gray scale images of the left ventricle in 3 complete cardiac cycles which were acquired in three short-axis views （including standard mitral annulus view,papillary muscle view,apical left ventricle short-axis view）.All two-dimensional dynamic images were analyzed off-line with a dedicated Syngo VVI workstation.the time to peak of systolic radial strain （PTrs） and time to peak of systolic circumferential strain （PTcs） were derived from the LV short axis views including 18 myocardial segments.The standard deviation of PTrs,PTcs （PTrs-SD,PTcs-SD） of 18 LV segments were calculated.Results Compared with the dyssynchrony index of normal control group,left ventricular asyn-chronization index in three groups increased,PTrs-SD,PTcs-SD with significant difference（P＜0.01）.Compared with the control group,In V1-6 T-wave inversion group PTrs of anterior,anteroseptal and anterolateral walls and PTcs of anteroseptal and inferoseptal walls delayed （P=0.00～0.02）.PTrs of anteroseptal wall In V1-4 T-wave inversion group and anterolateral wall in V3-6 T-wave inversion group delayed（P=0.02～0.03）.The contraction sequences of PTrs and PTcs in three T-wave inversion group were along clockwise and counterclockwise direction.The contraction sequence of PTrs and PTcs was from inferolateral wall to anteroseptal wall in V1-6 T-wave inversion group and V1-4T-wave inversion group.In V3-6 T-wave inversion group th