中山大学孙逸仙纪念医院心血管内科,广东 广州 510120
吕函璐,第一作者,研究方向:超声心动图在心血管疾病中的应用,E-mail:lvhanlu3@mail.sysu.edu.cn
收稿:2026-04-11,
修回:2026-05-11,
录用:2026-06-07,
网络首发:2026-07-21,
纸质出版:2026-07-20
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吕函璐,刘英梅.多模态超声心动图分析Brugada综合征隐匿性心肌机械功能异常[J].中山大学学报(医学科学版),2026,47(04):709-714.
LÜ Hanlu,LIU Yingmei.Multimodal Echocardiography for Subclinical Myocardial Mechanical Dysfunction in Brugada Syndrome[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(04):709-714.
吕函璐,刘英梅.多模态超声心动图分析Brugada综合征隐匿性心肌机械功能异常[J].中山大学学报(医学科学版),2026,47(04):709-714. DOI: 10.11714/jsysu.med.YX20260056.
LÜ Hanlu,LIU Yingmei.Multimodal Echocardiography for Subclinical Myocardial Mechanical Dysfunction in Brugada Syndrome[J].Journal of Sun Yat-sen University(Medical Sciences),2026,47(04):709-714. DOI: 10.11714/jsysu.med.YX20260056.
目的
2
应用多模态超声心动图技术分析Brugada综合征(BrS)患者的心肌机械功能特征,为BrS隐匿性心肌机械异常的临床评估提供影像学依据。
方法
2
纳入2020年1月至2023年12月于中山大学孙逸仙纪念医院确诊的BrS患者。采用斑点追踪超声心动图(STE)检测左室整体纵向应变(LV-GLS)、右室游离壁纵向应变(RVFW-LS)、右室整体纵向应变(RV-GLS)以及相应的机械离散度(LV-MD, RVFW-MD, RV-MD);通过组织多普勒成像(TDI)计算左室、右室心肌做功指数(LV-MPI, RV-MPI)。
结果
2
本中心5例BrS患者的常规心室收缩功能参数均在正常范围,而多模态超声参数存在明显个体差异:兼具自发性1型Brugada心电图与
SCN5A
基因突变的高危表型患者,可出现心肌做功指数升高(LV-MPI最高0.53,RV-MPI最高0.67)或机械离散度增加(LV-MD最高61 ms)。
结论
2
BrS 患者存在常规超声无法识别的隐匿性心肌机械功能异常。心肌做功指数联合 STE 多参数检测可揭示其亚临床心室功能及收缩同步性改变,提示多模态超声心动图对BrS亚临床心肌损伤评估具有潜在的影像学价值。
Objective
2
This study aimed to evaluate the myocardial mechanical characteristics in patients with Brugada syndrome (BrS) using multimodal echocardiography, to provide imaging evidence for the assessment of occult myocardial mechanical abnormalities in BrS.
Methods
2
Patients diagnosed with BrS in Sun Yat-sen Memorial Hospital between January 2020 and December 2023 were enrolled. Speckle-tracking echocardiography (STE) was performed to measure left ventricular global longitudinal strain (LV-GLS), right ventricular free wall longitudinal strain (RVFW-LS), and right ventricular global longitudinal strain (RV-GLS), as well as corresponding mechanical dispersion parameters (LV-MD, RVFW-MD, RV-MD). Left and right ventricular myocardial performance indices (LV-MPI, RV-MPI) were calculated using tissue Doppler imaging (TDI).
Results
2
All five BrS patients had normal conventional ventricular systolic function, while marked individual differences were observed in multimodal echocardiographic parameters. Patients with high-risk phenotype, characterized by both spontaneous type 1 Brugada electrocardiogram and
SCN5A
gene mutation, exhibited elevated myocardial performance indexes (maximum LV-MPI 0.53, maximum RV-MPI 0.67) or increased mechanical dispersion (maximum LV-MD 61 ms).
Conclusion
2
Patients with BrS present subclinical myocardial mechanical dysfunction undetectable by conventional echocardiography. Combined assessment of myocardial performance index and multi-parameter STE can identify subtle impairments in ventricular function and systolic synchronicity. Multimodal echocardiography has valuable potential for the assessment of subclinical myocardial injuries in BrS.
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