摘要
目的应用超声斑点跟踪技术(STI)评价原发性高血压患者的左心室收缩功能,探讨当左心室构型改变时,以二尖瓣环位移(MAD)作为评价左心室整体收缩功能指标的可行性和准确性。方法选择原发性高血压患者40例,其中左心室构型正常(LVN)20例,左心室重构(LVR)20例。对照组为健康志愿者30名。应用STI计算左心室收缩期整体峰值纵向应变(GLs)、圆周应变(GCs)、径向应变(GRs)、左心室扭转(LVtw)、MAD,并应用实时三维超声心动图计算左心室射血分数(LVEF)。比较LVN组、LVR组和对照组在心肌不同方向上应变的规律,并分析左心室GLs、GCs、GRs、LVtw与MDA和LVEF间的关系。结果①与对照组比较,LVN及LVR组的LVtw均显著高于对照组(P<0.05);LVN组参数除无明显变化,LVR组均明显减低(P<0.05)。②LVN组、LVR组和对照组的MAD与LVEF显著相关,r值分别为0.83、0.76和0.84。③LVR组的GCs、LVtw为LVEF的独立预测因子,beta值分别为-0.40、0.47(P<0.05)。④LVR组的GLs、GRs、GCs及LVtw与MAD显著相关,GLs是MAD的独立预测因子。结论 STI可以评价原发性高血压患者左心室发生构型改变时的整体功能变化。评价MAD有望成为临床观察高血压左心室整体收缩功能的快捷方法 。
Objective To observe the feasibility and the accuracy of mitral annulus displacement （MAD） with speckle tracking imaging （STI） for evaluation of the global systolic function of the left ventricular remodeling in patients with hypertension. Methods The study population enrolled 40 patients with essential hypertension including 20 cases with left ventricular normal geometry （LVN） and 20 cases with left ventricular remodeling （LVR）,as well as 30 age-and gender-matched healthy volunteers as the control group. The systolic parameters including longitudinal strain （GLs）,radial strain （GRs）,circumferential strain （GCs）,LV twist （LVtw） and MAD were obtained with STI,and LVEF was acquired with three dimensional echocardiography. The difference of these parameters among LVN,LVR and the control groups were compared,and the correlation among MAD,LVEF,GLs,GCs,GRs and LVtw were analyzed respectively. Results ①Compared with those in the control group,LVtw in LVN and LVR group were significantly higher （P〈0.05）,the other parameters in LVN group were not significantly different,while that in LVR group were significautly lower （P〈0.05）. ②Good correlation was found between MAD and LVEF in all three groups （r=0.83 [LVN],0.76 [LVR],0.84 [control]）. ③Multi-variant regression analysis indicated that LVtw and GCs were the independent predictors of LVEF in LVR group （beta=-0.40,0.47,P〈0.05）. ④Good correlation was showed between MAD and GLs,GRs,GCs and LVtw in LVR group,GLs was the independent predictor of MAD. Conclusion The global function of the left ventricular remodeling in patients with hypertension can be assessed with STI,and measurement MAD may be an easy and simple method for evaluation of the global systolic function of remodeling the left ventricle.
出处
《中国医学影像技术》
CSCD
北大核心
2010年第7期1254-1257,共4页
Chinese Journal of Medical Imaging Technology
关键词
高血压
斑点追踪显像
心室功能
左
Hypertension
Speckle tracking imaging
Ventricular function
left
