超声斑点追踪技术在肥厚型心肌病患者心功能评估及心肌纤维化预测中的作用  

Role of Ultrasound Speckle Tracking Imaging in Assessing Cardiac Function and Predicting Myocardial Fibrosis in Patients with Hypertrophic Cardiomyopathy

作　　者：吉洪花 吴雨歌 侯冬梅 魏文兵[4] JI Hong-hua;WU Yu-ge;HOU Dong-mei;WEI Wen-bing(Department of Ultrasound Medicine,Binzhou Hospital of Traditional Chinese Medicine,Binzhou,Shandong 256600,China;Department of Orthopedics,Binzhou Hospital of Traditional Chinese Medicine,Binzhou,Shandong 256600,China;College of Radiology,Shandong First Medical University,Binzhou,Shandong 256600,China;Department of Ultrasound Medicine,Binzhou People's Hospital Affiliated to Shandong First Medical University,Binzhou,Shandong 256600,China)

机构地区：[1]滨州市中医医院超声医学科,山东滨州256600 [2]滨州市中医医院骨科,山东滨州256600 [3]山东第一医科大学放射学院,山东滨州256600 [4]山东第一医科大学附属滨州市人民医院超声医学科,山东滨州256600

出　　处：《临床误诊误治》2023年第1期61-64,共4页Clinical Misdiagnosis & Mistherapy

基　　金：山东省医药卫生科技发展计划项目(2018WS215)。

摘　　要：目的探讨超声斑点追踪技术(STI)在肥厚型心肌病(HCM)患者心功能评估及心肌纤维化预测中的作用。方法选取2019年10月—2022年4月收治的128例HCM作为HCM组,另选取同期64例体检健康者作为对照组。比较2组超声心动图指标[左心室舒张末期内径(LVEDD)、室间隔舒张末期厚度(IVST)、二尖瓣口舒张早期血流速度峰值(E)、二尖瓣口舒张晚期血流速度峰值(A)、二尖瓣环根部舒张早期速度峰值(Ea)、二尖瓣环根部舒张晚期速度峰值(Aa)],三维应变参数[面积应变(GAS)、纵向应变(GLS)、圆周应变(GCS)及径向应变(GRS)],以及有无心肌纤维化HCM患者上述三维应变参数;并绘制受试者工作特征(ROC)曲线分析SIT三维应变参数预测HCM患者心肌纤维化发生的价值。结果HCM组IVST、E/Ea值明显高于对照组,LVEDD、E/A、Ea/Aa、GAS、GLS、GCS及GRS值明显低于对照组(P<0.01)。有心肌纤维化HCM患者GAS、GLS、GCS及GRS值均明显低于无心肌纤维化HCM患者(P<0.01)。ROC曲线分析显示,SIT三维应变参数GAS+GLS+GCS+GRS预测HCM患者心肌纤维化发生的曲线下面积、敏感度、特异度分别为0.869、0.890、0.804,均明显高于各项参数单一预测。结论STI可评估HCM患者心肌功能,并通过测量HCM患者三维应变参数可有效预测有无心肌纤维化发生。Objective To investigate the role of ultrasound speckle tracking imaging(STI)in cardiac function assessment and myocardial fibrosis prediction in patients with hypertrophic cardiomyopathy(HCM).Methods A total of 128 HCM patients admitted from October 2019 to April 2022 were selected as the HCM group,and 64 healthy people undergoing physical examination during the same period were selected as the control group.The echocardiographic indexes[left ventricular end diastolic diameter(LVEDD),end-diastolic interventricular septum thickness(IVST),early diastolic peak velocity(E),late diastolic peak velocity(A),early diastolic peak velocity(Ea)at the root of mitral annulus,and late diastolic peak velocity(Aa)at the root of mitral annulus],three dimensional strain parameters[global area strain(GAS),global longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain(GRS)],and the above three dimensional strain parameters in HCM patients with or without cardiac fibrosis were compared between the two groups.The receiver operating characteristic(ROC)curve was drawn to analyze the value of SIT three-dimensional strain parameters in predicting myocardial fibrosis in HCM patients.Results The values of IVST and E/Ea were significantly higher in HCM group than in the control group,while the values of LVEDD,E/A,Ea/Aa,GAS,GLS,GCS and GRS were significantly higher in HCM group than in control group(P<0.01).The values of GAS,GLS,GCS and GRS in HCM patients with myocardial fibrosis were significantly lower than those in HCM patients without myocardial fibrosis(P<0.01).The ROC curve analysis showed that the area under the curve,sensitivity,and specificity of the STI three-dimensional strain parameter GAS+GLS+GCS+GRS to predict the occurrence of myocardial fibrosis in HCM patients were 0.869,0.890,and 0.804,respectively,which were significantly higher than the prediction of each parameter alone.Conclusion STI can evaluate the myocardial function of HCM patients,and can effectively predict the presence or absence of t

关 键 词：心肌病 肥厚性 超声斑点追踪技术 左心室舒张末期前后径 心肌 纤维化 

分 类 号：R542.2[医药卫生—心血管疾病]