压力-应变环评价非梗阻性肥厚型心肌病早期左室收缩功能障碍的价值  

Applying pressure-strain loop to assess the change of early left ventricular systolic dysfunction in non-obstructive hypertrophic cardiomyopathy

作　　者：张瑞芳[1] 戴思露 段会参 王红鹄 武丽娜[1] 杜江川[1] 郭玮涛 宋新浩[1] 孔祥东[2] 安金斗[3] ZHANG Ruifang;DAI Silu;DUAN Huican;WANG Honghu;WU Lina;DU Jiangchuan;GUO Weitao;SONG Xinhao;KONG Xiangdong;AN Jindou(Department of the Ultrasound,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Genetic and Prenatal Diagnosis Center,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052;Department of Pediatric Medicine,the First Affiliated Hospital,Zhengzhou University,Zhengzhou 450052)

机构地区：[1]郑州大学第一附属医院超声医学科,郑州450052 [2]郑州大学第一附属医院遗传与产前诊断中心,郑州450052 [3]郑州大学第一附属医院小儿内科,郑州450052

出　　处：《郑州大学学报（医学版）》2023年第1期34-38,共5页Journal of Zhengzhou University(Medical Sciences)

基　　金：国家自然科学基金项目(81871364);河南省医学科技攻关计划省部共建项目(SBGJ2018014)。

摘　　要：目的:应用压力-应变环(PSL)定量分析非梗阻性肥厚型心肌病(HCM)左室整体及局部心肌做功变化,探讨其评价左室早期收缩功能障碍的应用价值。方法:连续纳入2020年9月至2021年4月在郑州大学第一附属医院就诊的非梗阻性HCM患者32例(HCM组);选取同期年龄匹配的32例体检健康者为正常对照。收集相关临床资料,所有研究对象均行超声心动图检查,比较两组左室整体纵向应变(GLS)、整体做功效率(GWE)、整体做功指数(GWI)、整体有效功(GCW)、整体无用功(GWW)以及各节段心肌做功指数(SWI)、纵向应变(SLS)之间的差异。采用Pearson相关分析心肌整体及各节段心肌做功和纵向应变之间的相关性。结果:与正常对照组相比,HCM组GLS、GWE、GWI、GCW均降低,GWW增加(P均<0.05);除心尖段外,HCM组心肌各节段SWI、SLS均较正常对照组降低(P均<0.05)。Pearson相关分析结果显示,GLS与GWE、GWI、GCW呈正相关(r=0.785、0.890、0.828,P<0.05),与GWW呈负相关(r=-0.668,P=0.006);各节段SWI与相应SLS之间具有良好的相关性,r值范围为0.649~0.928(P均<0.05)。结论:PSL定量评价左室早期收缩功能障碍可为HCM患者的诊治提供更多有价值的信息。Aim:To quantitatively analyze the change of left ventricular global and regional myocardial work applying pressure-strain loop(PSL),and explore the value of PSL assessing early systolic dysfunction in patients with non-obstructive hypertrophic cardiomyopathy(HCM).Methods:Thirty-two patients with non-obstructive HCM(HCM group) and 32 healthy volunteers(normal control group) who were admitted to the First Affiliated Hospital of Zhengzhou University from September 2020 to April 2021 were consecutively included.All subjects underwent transthoracic echocardiography and relevant clinical information collection.Comparing the following parameters between two groups: global longitudinal strain(GLS),global work efficiency(GWE),global work index(GWI),global constructive work(GCW),global wasted work(GWW),segmental longitudinal strain(SLS) and segmental myocardial work index(SWI).Pearson statistics were used to analyze the correlation between myocardial work and longitudinal strain.Results:GLS,GWI,GCW,GWE were significantly reduced, while GWW was increased in HCM group compared with normal control group(P<0.05).Except the apical segments, SWI and SLS were significantly decreased in HCM group(P<0.05).Pearson analysis showed that GLS was positively correlated with GWI,GCW,GWE(r=0.890,0.828,0.785,P<0.05),while negatively correlated with GWW(r=-0.668,P=0.006).There was a good correlation between SWI and SLS in each segment, with a range of r value thresholds from 0.649 to 0.928(P<0.05).Conclusion:PSL could provide more valuable information by quantitatively evaluating early left ventricular systolic dysfunction of non-obstructive HCM patients.

关 键 词：压力-应变环 非梗阻性肥厚型心肌病 收缩功能障碍 

分 类 号：R541[医药卫生—心血管疾病]