左室压力-应变环技术评估甲状腺功能减退患者左室心肌做功  

Assessment of myocardial work in patients with hypothyroidism by left ventricular pressure-strain loop technology

作　　者：彭熠 张莉 王锐[3] 朱浩[3] 尹立雪[3] PENG Yi;ZHANG Li;WANG Rui;ZHU Hao;YIN Lixue(North Sichuan Medical College,Sichuan 637000,China)

机构地区：[1]川北医学院,四川省南充市637000 [2]西南医科大学 [3]电子科技大学附属医院四川省人民医院超声医学研究所超声心脏电生理学与生物力学四川省重点实验室

出　　处：《临床超声医学杂志》2023年第5期367-371,共5页Journal of Clinical Ultrasound in Medicine

基　　金：国家重点研发计划项目(2020YFC2008000);国家自然科学基金项目(81671852);中央高校基本科研业务基金项目(ZYGX2020ZB038)。

摘　　要：目的应用左室压力-应变环(LV-PSL)技术评估甲状腺功能减退患者左室心肌做功情况,探讨其临床价值。方法连续纳入于四川省人民医院就诊的甲状腺功能减退患者42例(甲减组),另选健康志愿者44例为对照组。应用常规超声心动图获取舒张末期室间隔厚度(IVSd)、舒张末期左室后壁厚度(LVPWd)、二尖瓣口舒张早期和晚期血流峰值速度(E、A)、左室侧壁二尖瓣环舒张早期和晚期运动峰值速度(e’、a’)、左室射血分数(LVEF),并计算E/A和E/e’;应用斑点追踪技术获取左室整体纵向应变(GLS),LV-PSL技术获取心肌整体做功指数(GWI)、整体做功效率(GWE)、整体有效做功(GCW)、整体无效做功(GWW),计算左室基底段、中间段和心尖段心肌做功指数(MWI)、做功效率(MWE)、有效做功(CW)、无效做功(WW),比较两组上述参数的差异。结果①常规超声心动图参数比较:与对照组比较,甲减组IVSd、LVPWd均增高,E、A、e’、E/A均降低,差异均有统计学意义(均P<0.05);两组LVEF、a’、E/e’比较差异均无统计学意义;②左室整体心功能参数比较:与对照组比较,甲减组GWW增高,GLS、GWI、GCW、GWE均降低,差异均有统计学意义(均P<0.05);③左室各节段心肌做功参数比较:与对照组比较,甲减组基底段、中间段和心尖段MWI、MWE、CW均降低,WW增高,差异均有统计学意义(均P<0.05)。结论LV-PSL技术能够定量评估甲状腺功能减退患者左室心肌做功情况,为临床早期诊治和疗效评估提供影像学依据。Objective To investigate the clinical value of myocardial work in patients with hypothyroidism by left ventricular pressure-strain loop(LV-PSL)technology.Methods A total of 42 patients with hypothyroidism treated in Sichuan Provincial People’s Hospital were included as the hypothyroidism group,and 44 healthy volunteers were employed as the control group.The interventricular septal thickness at end-diastole(IVSd),left ventricular posterior wall thickness at end-diastole(LVPWd),early and late diastolic peak velocity of mitral valve orifice(E,A),early and late diastolic mitral annular peak velocity of left ventricular lateral wall(e’,a’),left ventricular ejection fraction(LVEF),E/A,E/e’were obtained by conventional echocardiography.Left ventricular global longitudinal strain(GLS)was obtained by speckle tracking imaging technology.The global work index(GWI),global work efficiency(GWE),global constructive work(GCW),global wasted work(GWW)were obtained by LV-PSL technology.The average values of myocardial work index(MWI),myocardial work efficiency(MWE),constructive work(CW)and wasted work(WW)of basal,middle and apical segments of myocardium were calculated.The differences of the above parameters were compared between the two groups.Results①Comparision of conventional echocardiographic parameters:compared with the control group,IVSd and LVPWd were increased,and E,A,e’and E/A were decreased in the hypothyroidism group,with statistical significance(all P<0.05).There were no significant differences in LVEF,a’and E/e’between the two groups.②Comparision of left ventricular global cardiac function parameters:compared with the control group,GWW was increased and GLS,GWI,GCW and GWE were decreased in the hypothyroidism group,with statistical significance(all P<0.05).③Comparision of myocardial work parameters of each segment of left ventricle:compared with the control group,MWI,CW and MWE of basal,middle and apical segments in the hypothyroidism group were decreased,while WW were increased.The differences wer

关 键 词：超声心动描记术 压力-应变环 心肌做功 甲状腺功能减退 心室 左 

分 类 号：R540.45[医药卫生—心血管疾病] R581.2[医药卫生—内科学]