左心房容积指数在左心室舒张功能评估中的价值  

Value of left atrial volume index in assessment of left ventricular diastolic function

作　　者：高红英 王志斌[1] 付秀秀[1] 王吴刚[1] 穆柯晓[2] GAO Hongying;WANG Zhibin;FU Xiuxiu;WANG Wugang;MU Kexiao(Department of Cardiac Ultrasound,the Affiliated Hospital of Qingdao University,Qingdao,266003,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266003 [2]山东中医药大学第二附属医院超声科,山东济南250001

出　　处：《中国中西医结合影像学杂志》2018年第2期145-148,共4页Chinese Imaging Journal of Integrated Traditional and Western Medicine

摘　　要：目的:探讨高血压患者左心房参数与左心室舒张功能降低之间的相关性。方法:选取原发性高血压患者90例作为高血压组,50例健康志愿者作为对照组。传统超声心动图测量左心房内径、左心房容积,根据体表面积计算左心房内径指数和左心房容积指数(LAVI)。通过脉冲多普勒测量舒张早期二尖瓣口最大前向血流速度E峰、舒张晚期前向血流速度A峰及减速时间,得到E/A。利用组织多普勒测量室间隔侧二尖瓣环运动速度Em,计算E/Em,并获取左心室壁18节段舒张期早期和晚期心肌应变和应变率,记录舒张功能降低的心室节段总数。结果:(1)与对照组比较,高血压组左心房内径及容积显著增大(均P<0.05),且舒张功能降低心室节段数明显多于对照组(P<0.05)。(2)根据LAVI将高血压患者分为3组:A组(正常组)、B组(轻度扩大组)和C组(中重度扩大组)。与A组比较,B组和C组舒张功能降低心室节段总数、E/Em均增加(均P<0.05);B、C组Em均降低(均P<0.05)。(3)LAVI与舒张功能降低心室节段总数及E/Em呈正相关(r=0.89,0.92;均P<0.01),与Em呈负相关(r=-0.86)。结论:左心房重构与左心室舒张功能密切相关,LAVI与E/Em呈良好的相关性,LAVI可评估左心室舒张功能。Objective:The purpose of this study was to investigate the correlation between left atrial parameters and left ventricular diastolic dysfunction in essential hypertensive patients and the correlation with E/Em parameters.Methods:90 patients with essential hypertension as hypertension group and 50 healthy volunteers as control group,left atrial index,including left atrial diameter(LAD),left atrial volume(LAV)were measured by conventional echocardiography.According to the body surface area(BSA),calculating left atial dimension index(LADI)and left atrial volume index(LAVI).LV diastolic function was assessed by measurements of peak early transmitral flow velocity(E)、peak late transmitral flow velocity(A)by adopting PW-Doppler(the E/A ratio),peak early diastolic mitral annular velocity(Em)by adopting tissue Doppler and the E/Em ratio.In addition,18 left ventricular wall segments in the early and late diastolic myocardial strain and strain rate obtained by tissue Doppler,record the total heart diastolic function decreased ventricular segment number.Results:Compared with normal control group,left atrial diameter and volume were significantly increased in patients with hypertension(P<0.05),and ventricular diastolic dysfunction was significantly higher than the normal control group(all P<0.05);according to the left atrial volume index(LAVI),the cases of hypertension were divided into three groups:group A(left atrial size in normal group),group B(mild left atrial enlargement group)and group C(severe left atrium enlargement group).Compared with group A,total number of ventricular diastolic dysfunction segments and E/Em in group B and group C increased(P<0.05).Compared with group A,the Mean Em in group B and C were decreased(P<0.05).LAVI was positively correlated with total ventricular segment with diastolic dysfunction and E/Em(r=0.89,r=0.92,P<0.01).Conclusion:The left atrium remodeling is closely related to the left ventricular diastolic function,and the left atrial volume index(LAVI)has a good correlation with E/Em,and

关 键 词：超声心动描记术 应变 高血压 心房 心室功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R541.3[医药卫生—内科学]