三维面积应变评价高血压患者左心室心肌收缩功能早期变化  

Three-dimensional area strain in evaluating the changes of left ventricular myocardial contractional function in patients with hypertension

作　　者：孙璐[1] 任卫东[1] 樊蓉[1] 乔伟[1] 肖杨杰[1] 徐威[1] 

机构地区：[1]中国医科大学附属盛京医院超声科,辽宁沈阳110004

出　　处：《中国医学影像技术》2014年第9期1348-1352,共5页Chinese Journal of Medical Imaging Technology

摘　　要：目的应用三维斑点追踪成像(3D-STE)技术评价原发性高血压患者早期左心室心肌收缩功能改变情况。方法对40例未经药物治疗的原发性高血压患者(高血压组)及40名健康志愿者(对照组)行常规二维超声心动图和3DSTE,测量并比较两组常规超声心动图指标包括舒张末期室间隔厚度(IVSTd)、舒张末期左心室后壁厚度(LVPWTd)、左心室舒张末期内径(LVEDd)、相对室壁厚度(RWT)、二维左心室心肌质量指数(2D-LVMi)、二维左心室射血分数(2DLVEF)、舒张末期左心室容积(EDV)、收缩末期左心室容积(ESV),以及3D-STE指标包括左心室三维射血分数(3D-LVEF)、左心室球形指数(SPI)、三维左心室心肌质量指数(3D-LVMi)及左心室整体面积应变(GAS)差异;采用Pearson相关分析检验GAS与各指标间相关性。结果两组患者IVSTd、LVPWTd、LVEDd、RWT、2D-LVMi、2D-LVEF、EDV、ESV、3D-LVEF和SPI差异均无统计学差异(P均>0.05);高血压组3D-LVMi高于对照组[(104.20±7.94)vs(92.85±6.92),P<0.05),GAS低于对照组[(-25.53±3.79)vs(-31.43±3.13),P<0.05]。GAS与3D-EF呈负相关(r=-0.78,P<0.05),与3D-LVMi、收缩压及舒张压呈正相关(r=0.81、0.60、0.50,P<0.05)。结论原发性高血压患者早期左心室构型未发生明显变化时,左心室心肌收缩功能已经减低,可通过3D-STE中GAS进行评价。Objective To assess the early changes of left ventricular myocardial contractional function in untreated patients of primary hypertension patients with three-dimensional speckle-tracking echocardiography （3D-STE）. Methods Totally 40 untreated patients of primary hypertension patients （hypertension group） and 40 healthy volunteers （control group） underwent standard two-dimensional echocardiography and 3D-STE. Parameters of two-dimensional echocardiography including interventricular septal thickness at end-diastole （IVSTd）, left ventricular posterior wall thickness at end- diastole （LVPWTd）, left ventricular at end-diastolic diameter （LVEDd）, relative wall thickness （RWT）, two-dimensional left ventricular mass index （2D-LVMi）, two-dimensional left ventricular ejection fraction （2D-LVEF）, end-diastolic volume （EDV）, end-systolic volume （ESV）, and parameters of 3D-STE including three-dimensional left ventricular ejection fraction （3D-LVEF）, sphericity index （SPI）, three-dimensional LV mass index （3D-LVMi）, and global area strain （GAS） were calculated and compared. The correlations of GAS with above parameters were analyzed. Results There were no significant differences of IVSTd, LVPWTd, LVEDd, RWT, 2D-LVMi, 2D-LVEF, EDV, ESV, 3D-LVEF, and SPI between the two groups. 3D-LVMi was significant higher and GAS was significant lower in hypertension group than those in control group （3D-LVMi： [104.20±7.94] vs [92.85±6.92], GAS [--25.53±3.79] vs [--31.43±3.13], both P〈 0.05）. It showed a negative correlation between GAS and 3D-EF （r= -0.78, P%0.05）, and positive correlations between GAS and 3D-LVMi, systolic blood pressure and diastolic blood pressure （r= 0.81, 0.60, 0.50, all P〈0.05）. Conclusion On the early stages of hypertension, the left ventricular myocardial contractive function has reduced before the configuration changes, which can be detected by 3D-STE with GAS.

关 键 词：超声心动描记术 三维 高血压 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病]