速度向量成像技术评价原发性高血压左心室无肥厚构型患者局部心肌功能  

Velocity vector imaging assessment of regional function of left ventricular myocardium in hypertension patients without left ventricular hypertrophy

作　　者：刘海涛[1] 周长钰[1] 梁燕[2] 蒋荷娟[2] 

机构地区：[1]天津医科大学第二医院心内科,天津300211 [2]海洋石油总医院超声科,天津300452

出　　处：《中国医学影像技术》2012年第3期483-487,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的探讨VVI技术对原发性高血压患者左心室舒缩功能早期变化的预测价值。方法选取80例正常构型高血压患者(NG组)和45例向心性重构高血压患者(CR组),以80名血压正常者(NC组)为对照。常规超声测定左心室舒张末内径(LVIDd)、室间隔厚径(IVST)、左心室后壁厚径(LVPWT)、射血分数(LVEF)、二尖瓣口舒张期血流频谱E、A峰比值,在VVI条件下采集左心室短轴乳头肌水平二维图像,检测收缩期和舒张期左心室前壁、侧壁、后壁、下壁及前后间隔各节段心肌周向应变和应变率。结果 3组间LVEF值差异无统计学意义(P>0.05),CR组E/A比值低于NC组和NG组(P<0.05)。CR组局部心肌收缩期峰值应变、应变率及舒张早期局部心肌应变率均低于NC组和NG组(P<0.05);NG组舒张早期局部心肌应变率低于NC组(P<0.05),收缩期局部心肌应变和应变率与NC组相比未见明显差异(P>0.05)。3组间舒张晚期局部心肌应变率无统计学意义(P>0.05)。结论VVI技术可定量评价左心室局部功能,早期发现高血压患者局部心肌的收缩及舒张功能障碍。舒张早期局部心肌应变率减低可能是高血压患者心功能的较早期改变。Objective To observe the value of VVI in detection of left ventricular systolic and diastolic changes at early stage hypertension parients.Methods Eighty patients with normal geometry（NG group）,45 patients with concentric remodeling（CR group） and 80 healthy people（NC group） were enrolled.Echocardiographic examination was performed to acquire parameters including left ventricular internal dimension in diastole（LVIDd）,interventricular sepal thickness（IVST）,left ventricular posterior wall thickness（LVPWT）,left ventricular ejection fraction（LVEF） and transmitral diastolic inflow velocities（E,A）.Strain and strain rate data（SR） were obtained from the left mid ventricular short-axis view using VVI.Circumferential strain and strain rate of anterior wall,lateral wall,posterior wall,inferior wall,anterior and inferior septum were analyzed using offline software of VVI.Results LVEF appeared no difference among 3 groups（P0.05）,E/A of CR was lower than that of NC and NG（P0.05）.Peak systolic strain,SR and early diastolic SR of regional ventricular myocardium in CR group were lower than those in NC and NG（P0.05）.Regional ventricular myocardium of NG group had lower early diastolic SR than NC group（P0.05）,while peak systolic strain and SR showed no difference to NC group（P0.05）.Lately diastolic SR appeared no difference among three groups（P0.05）.Conclusion VVI is valuable for accurate evaluation of regional function of left ventricular,being able to discover abnormal regional systolic and diastolic function of left ventricular of hypertension patients in early period.Lower early diastolic SR of regional ventricular myocardium may be the earlier change of heart function in hypertensive individuals.

关 键 词：高血压 肥大 左心室 局部心功能 速度向量成像 

分 类 号：R544.1[医药卫生—心血管疾病] R540.45[医药卫生—内科学]