三维斑点追踪技术评估主动脉瓣反流患者亚临床左心室收缩功能受损价值  

Value of three-dimensional speckle tracking echocardiography to evaluating subclinical left ventricular systolic dysfunction in patients with aortic regurgitation

作　　者：闫晓妮[1] 陈瑛[1] 汪越君 朱利飞 

机构地区：[1]榆林市第一医院超声科,陕西榆林719000

出　　处：《中华实用诊断与治疗杂志》2016年第9期908-910,共3页Journal of Chinese Practical Diagnosis and Therapy

摘　　要：目的探讨三维斑点追踪技术在评价主动脉瓣反流(aortic regurgitation,AR)患者亚临床左心室心肌损伤中的价值。方法左室射血分数正常AR患者71例,其中轻度反流31例,中度反流21例,重度反流19例;同期30例体检健康者为对照组。各组均应用三维斑点追踪技术行超声心动图检查,测量左心室三维整体纵向应变(three-dimensional global longitudinal strain,3D-GLS)、三维整体径向应变(three-dimensional global radial strain,3D-GRS)、三维整体面积应变(three-dimensional global area strain,3D-GAS)及三维整体圆周应变(three-dimensional global circumferential strain,3D-GCS),并进行比较。结果轻度反流组|3D-GLS|[(18.6±2.8)%]、|3D-GAS|[(30.6±4.7)%]、|3D-GCS|[(18.6±3.1)%]以及3D-GRS[(38.1±6.2)%]与对照组[(19.1±3.3)%、(30.1±5.7)%、(19.2±5.3)%、(40.1±6.3)%]比较差异无统计学意义(P>0.05);中度反流组|3D-GLS|[(17.1±3.1)%]、|3D-GAS|[(26.1±4.1)%]低于对照组(P<0.05);重度反流组|3D-GLS|[(14.2±3.2)%]、|3D-GAS|[(20.1±3.9)%]、|3D-GCS|[(15.7±4.0)%]、3D-GRS[(33.4±6.2)%]均低于对照组,|3D-GLS|、|3D-GAS|低于中度反流组(P<0.05)。结论左室射血分数正常中、重度AR患者左心室已出现亚临床心肌损伤,三维斑点追踪技术可用于评估AR患者左心室亚临床心肌损伤。Objective To investigate the value of three-dimensional speckle tracking echocardiography （3D-STE） to detecting subclinical left ventricular systolic dysfunction in patients with aortic regurgitation （AR）. Methods Seventy-one patients with AR and normal left ventricular ejection fraction （LVEF） included 31 patients with mild AR, 21 patients with moderate AR and 19 patients with severe AR. Another 30 healthy volunteers were as controls （control group）. All patients received 3D-STE to measure and compare three-dimensional global longitudinal strain （3D-GLS）, three-dimensional global radial strain （3D-GRS）, three-dimensional global area strain （3D-GAS） and three-dimensional global circumferential strain （3D-GCS）. Results There were no significant differences in the values of ｜3D-GLS｜ （（18.6±2.8）% vs （19.1±3.3）%）, ｜3D-GAS｜ （（30.6±4.7）% vs （30.1±5. 7）%）,｜3D-GCS｜ （（18.6±3.1）% vs （19.2±5.3）%） and 3D-GRS （（38.1±6.2）% vs （40. 1±6.3）%） between mild AR patients and control group （P〉 0.05）. The values of ｜ 3D-GLS｜ and｜3D-GAS｜ were significantly lower in moderate AR patients （（17. 1 ±3. 1）%, （26.1±4.1）%） than those in control group （P〈0.05）. The values of ｜3D-GLS｜ （（14. 2±3. 2）%）, ｜3D-GAS｜ （（20.1±3.9）%）, ｜ 3D-GCS｜ （（15. 7±4.0）%） and 3D-GRS （（33.4±6.2）%） were significantly lower in severe AD patients than those in control group, and ｜3D-GLS｜ and ｜ 3D-GAS｜ were significantly lower than those in moderate AD patients （P〈0.05）. Conclusion The patients with moderate or severe AR have evidence of subclinical left ventricular systolic dysfunction though LVEF is normal. 3D-STE can be used to evaluate subclinical left ventricular dysfunction in AR patients.

关 键 词：主动脉瓣反流 三维斑点追踪技术 亚临床左心室收缩功能障碍 

分 类 号：R542.5[医药卫生—心血管疾病]