慢性心力衰竭患者三维斑点追踪成像特征及与MMP-9/TIMP-1水平和远期预后的关系  

Characteristics of Three-dimensional Speckle Tracking Imaging in Patients with Chronic Heart Failure and Its Relationship with MMP-9/TIMP-1 System and Long-term Prognosis

作　　者：刘开全[1] 金碧 唐伟 LIU Kai-quan;JING Bi;TANG Wei(Department of Ultrasound Medicine,Qionglai Medical Center Hospital,Chengdu 611530,China)

机构地区：[1]四川省邛崃市医疗中心医院超声医学科,成都611530

出　　处：《微循环学杂志》2022年第3期57-60,共4页Chinese Journal of Microcirculation

摘　　要：目的:研究慢性心力衰竭(CHF)患者三维斑点追踪成像的特征及其与基质金属蛋白酶-9(MMP-9)/金属蛋白酶组织抑制剂-1(TIMP-1)水平和远期预后的关系。方法:选择2017-01-2020-03本院收治的CHF患者102例作为CHF组,依据NYHA分级将其分为Ⅱ级组(n=33)、Ⅲ级组(n=44)和Ⅳ级组(n=25)三个亚组,同期体检的120例健康者作为对照组。行左室三维斑点追踪成像并检测整体长轴应变(GLS)、整体径向应变(GRS)、整体环向应变(GCS),采用超声心动图检测左室射血分数(LVEF),采用酶联免疫吸附法检测血清BNP前体氨基末端(NT-proBNP)、MMP-9、TIMP-1水平,随访CHF患者1年内主要不良心血管事件(MACE)的发生情况。结果:CHF组患者的三维斑点追踪成像参数GLS、GRS、GCS水平均低于对照组(P<0.01)。在CHF组亚组中,GLS的水平呈Ⅱ级组>Ⅲ级组>Ⅳ级组(P<0.05),各亚组间GRS及GCS的水平无显著差异(P>0.05);CHF患者GLS水平与LVEF呈正相关,与NT-proBNP、MMP-9、TIMP-1呈负相关(P均<0.01);GLS水平对CHF患者MACE的发生具有预测价值。结论:三维斑点追踪成像参数GLS水平可评价CHF患者心脏结构变化,预测MACE发生。Objective: To study the characteristics of three-dimensional speckle tracking imaging in patients with chronic heart failure(CHF) and its relationship with matrix metalloproteinase-9(MMP-9)/tissue inhibitor of metalloproteinase-1(TIMP-1) system and long-term prognosis. Method: Patients with CHF from January 2017 to March 2020 were selected as CHF group. According to NYHA classification, CHF group was divided into three subgroups: class Ⅱ group(n=33), class Ⅲ group(n=44) and class Ⅳ group(n=25). 120 healthy persons who underwent physical examination at the same time as the control group. Three dimensional speckle tracking imaging of left ventricle was performed, and the global long strain(GLS), global radial strain(GRS) and global circumferential strain(GCS) were detected. The left ventricular ejection fraction(LVEF) was detected by echocardiography. The levels of serum BNP precursor amino terminal(NT-proBNP), MMP-9 and TIMP-1 were detected by enzyme-linked immunosorbent assay. The incidence of major adverse cardiovascular events(MACE) in CHF patients within 1 year was followed up. Results: The levels of three-dimensional speckle tracking imaging parameters GLS, GRS and GCS in CHF group were lower than those in the control group(P<0.01). In the CHF subgroup, the level of GLS in class Ⅱ group was higher than that in class Ⅲ group, and class Ⅳ group was the lowest(P<0.05).There was no significant difference in the levels of GRS and GCS among CHF subgroup(P>0.05). In CHF patients,GLS levels were positively correlated with LVEF and negatively associated with NT-proBNP,MMP-9,and TIMP-1(P<0.05);Through ROC curve analysis,GLS level had predictive value for MACE.Conclusion:The GLS of 3d speck tracking imaging parameters can be used to evaluate the cardiac structural changes of CHF patients,and predict the long-term MACE.

关 键 词：慢性心力衰竭 三维斑点追踪成像 基质金属蛋白酶-9 金属蛋白酶组织抑制剂-1 

分 类 号：R540.4[医药卫生—心血管疾病]