左室压力-应变环对非梗阻型肥厚型心肌病患者整体心肌做功的定量研究  

Quantitative Evaluation of Left Ventricular Global Myocardial Work in Patients With Non-obstructive Hypertrophic Cardiomyopathy By Pressure-strain Loops

作　　者：赵庆庆 刘琳 崔存英 李亚南 刘园园 刘瑞杰 逄坤静 Zhao Qingqing;Liu Lin;Cui Cunying;Li Ya′nan;Liu Yuanyuan;Liu Ruijie;Pang Kunjing(Zhengzhou University People′s Hospital,He′nan Provincial People′s Hospital,Fuwai Central China Cardiovascular Hospital,He'nan 450003,China;Chinese Academy of Medical Sciences,Fuwai Hospital,Beijing 100037,China)

机构地区：[1]郑州大学人民医院,河南省人民医院,阜外华中心血管病医院超声科,郑州市450003 [2]中国医学科学院阜外医院超声科

出　　处：《中国超声医学杂志》2020年第9期795-798,共4页Chinese Journal of Ultrasound in Medicine

基　　金：河南省医学科技攻关计划项目(No.2018020452)。

摘　　要：目的探讨左室压力-应变环(PSL)评价非梗阻型肥厚型心肌病(NHCM)患者左心室整体心肌做功的应用价值。方法选取30例NHCM患者和30例健康体检者,所有研究对象均行常规超声心动图检查,采集标准心尖三腔心、四腔心、两腔心切面动态图像,应用左室PSL分析左心室整体心肌做功,比较两组间整体纵向应变(GLS)、整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)的差异,采用Pearson统计学方法分析心肌做功参数与GLS的相关性。结果与对照组相比,病例组GLS、GWI、GCW、GWE均明显减低,差异有统计学意义(P<0.05),GWW差异无统计学意义(P>0.05);GWI、GCW、GWE与GLS均呈负相关,相关系数分别为(r=-0.934、-0.935、-0.731,P=0.000)。结论左室PSL比左室射血分数(LVEF)更敏感地检测NHCM患者整体心肌做功的改变,进而评估左室收缩功能,为临床诊断提供一种新的参考指标。Objective To investigate the application value of left ventricular pressure-strain loops(PSL)in evaluating global myocardial work in patients with hypertrophic cardiomyopathy(NHCM).Methods 30 NHCM patients and 30 normal controls were collected.All the selectors underwent Echocardiography examination,Dynamic images of standard apical three-chamber,four-chamber and two-chamber view were collected.Global myocardial work was evaluated by left ventricular PSL.The differences of left ventricular global longitudinal strain(GLS)myocardial global work index(GWI),global constructive work(GCW),global wasted work(GWW)and global work efficiency(GWE)between the two groups were compared.Pearson statistical method was used to analyze the correlation between GLS and myocardial work parameters.Results Compared with the control group,GLS,GWI,GCW and GWE in the case group were significantly reduced,and the differences between the two groups were statistically significant(P<0.05),GWW were not statistically significant(P>0.05).Pearson correlation analysis showed that GWI,GCW,GWE and GLS were negatively correlated,and the correlation coefficients were(r=-0.934,-0.935,-0.731,P=0.000).Conclusions Left ventricular PSL is more sensitive than LVEF to detect changes in global myocardial work in NHCM patients,then evaluate left ventricular systolic function,providing a new reference for clinical diagnosis.

关 键 词：肥厚型心肌病 超声心动图 压力-应变环 心肌做功 心室功能 左 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.2[医药卫生—诊断学]