斑点追踪成像评价左心室构型正常的原发性高血压心肌功能  

Myocardial Function Evaluation in Primary Hypertension with Normal Left Ventricular Geometry Using Speckle Tracking Imaging

作　　者：张楠[1] 李艳[1] 王志斌[1] 李勇[1] 孙品[1] 付秀秀[1] 

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003

出　　处：《中国医学影像学杂志》2014年第4期268-271,277,共5页Chinese Journal of Medical Imaging

摘　　要：目的采用斑点追踪成像评价左心室构型正常的原发性高血压患者早期心肌功能,为评价心肌功能的受损程度提供依据。资料与方法选取A组左心室舒张充盈正常的40例高血压患者、B组左心室松弛性减低的40例高血压患者和30例正常对照者,应用斑点追踪成像分别测量左心室整体心肌和心内膜下心肌收缩期长轴应变率(GSrL S)、舒张早期长轴应变率(GSrL E)、房缩期长轴应变率(GSrL A),心底水平旋转角度峰值(MV-Prot)、心尖水平旋转角度峰值(AP-Prot)、等容解扭转率(UntwR)等左心室扭转参数。结果与对照组相比,A组心内膜下心肌GSrL S减低,GSrL A增高(P<0.05);A、B组MV-Prot、AP-Prot较对照组增加,UntwR减低,解旋减半时间延长(P<0.05);B组AP-Prot较A组增加(P<0.05),UntwR减低(P<0.05)。结论应用斑点追踪成像检测原发性高血压患者左心室长轴心内膜下心肌的应变率和扭转参数可以定量分析心肌的应变情况,评价患者早期左心室心肌舒张及收缩功能的损伤。Purpose Speckle tracking imaging is used for the evaluation of early myocardial function in primary hypertension patients with normal left ventricular geometry, so as to provide the basis for myocardial function damage evaluation. Materials and Methods Forty hypertension patients with normal left ventricular diastolic filling was enrolled in group A, 40 hypertension patients with decreased left ventricular relaxation was enrolled in group B and 30 normal controls were enrolled in the control group, left ventricular myocardium and endocardium global peak systolic longitudinal strain rate （GSrL S）, global peak early diastolic longitudinal strain rate （GSrL E）, global peak LV systolic longitudinal strain rate （GSrL A）, and left ventricular twisting parameters such as twist at mitral valve opening （MV-Prot）, twist at aortic valve closure （AP-Prot） and untwisting rate （UntwR） were measured with speckle tracking imaging. Results Compared with the control group, subendocardial myocardial GSrL S decreased and GSrL A increased （P〈0.05） in group A; MV-Prot, AP-Prot increased and UntwR reduced in group A and group B compared with those in the control group, with obviously prolonged half unwinding time （P〈0.05）; AP-Prot of group B was higher （P〈0.05） and UntwR was lower than group A （P〈0.05）. Conclusion Myocardial strain state can be quantitative analyzed and early left ventricular diastolic and systolic function damage can be evaluated for patients with primary hypertension when using speckle tracking to detect the left ventricular long axis subendocardial myocardial strain rate and torsional parameters.

关 键 词：高血压 超声心动描记术 多普勒  彩色 斑点追踪成像 心室功能 左 心肌 

分 类 号：R541.3[医药卫生—心血管疾病] R445.1[医药卫生—内科学]