三维斑点追踪技术评价高血压患者左室功能与升主动脉弹性之间的关系  

Correlation Between Left Ventricular Function and Ascending Aortic Elasticity in Hypertensive Patients by Three-Dimensional Speckle Tracking Imaging

作　　者：李心怡 周畅[1] 孙恒 聂淑婷 胡文姝 刘蓉[1] 鲍荣辉[1] 周军[1] Li Xinyi;Zhou Chang;Sun Heng;Nie Shuting;Hu Wenshu;Liu Rong;Bao Ronghui;Zhou Jun(Department of Ultrasound,Yichang Central People's Hosptial,The First College of Clinical Medical Science,China Three Gorges University,Yichang 443003,China)

机构地区：[1]三峡大学第一临床医学院[宜昌市中心人民医院]超声科,湖北宜昌443003

出　　处：《巴楚医学》2023年第3期45-51,共7页Bachu Medical Journal

基　　金：湖北省卫生计生委面上项目(No:WJ2017M225);宜昌市医疗卫生研究项目(No:A23-1-019)。

摘　　要：目的:应用三维斑点追踪成像技术(3D-STI)评价原发性高血压患者左室收缩功能的变化,并分析其与升主动脉弹性之间的相关性。方法:选取2022年10月—2023年3月于宜昌市中心人民医院就诊的70例原发性高血压患者作为研究对象(高血压组),43例健康体检者作为对照组。应用3D-STI获取左室功能参数,包括整体纵向应变(GLS)、环向应变(GCS)、径向应变(GRS)、扭转角度峰值(LVPtw)、收缩不同步指数(SDI)以及扭矩(Torsion)。应用M型超声获取升主动脉弹性参数,即升主动脉应变(AS)、僵硬指数(ASI)、顺应性(AC)、扩张性(ADIS)和压力-应变弹性系数(AEp)。比较上述参数在两组之间差异并采用Spearman法比较高血压组患者左室功能与升主动脉弹性间相关性。结果:与对照组比较,高血压组GLS、GCS、GRS、AS、ADIS和AC均明显降低(均P<0.05),LVPtw、SDI、Torsion、ASI及AEp均显著增高(均P<0.05)。相关性分析显示,高血压组患者LVPtw、Torsion与AS、ADIS和AC呈负相关,与ASI和AEp呈正相关(均P<0.05);SDI与AS和ADIS呈负相关,与ASI和AEp呈正相关(均P<0.05)。结论:三维斑点追踪技术可评价原发性高血压患者左室收缩功能的变化,左室扭转运动的增加及心肌运动不同步与升主动脉弹性的降低有一定相关性。Objective:Three-dimensional speckle tracking imaging(3D-STI)was used to evaluate the changes of left ventricular systolic function in patients with essential hypertension(EH),and to analyze the correlation between these changes and the elasticity of ascending aorta.Methods:A total of 70 patients with essential hypertension in Yichang Central People's Hosptial from October 2022 to March 2023 were selected as the study subjects(EH group),and 43 healthy subjects were selected as the control group.3D-STI was used to detect left ventricular functional parameters,including global longitudinal strain(GLS),global circular strain(GCS),global radial strain(GRS),left ventricular peak twist(LVPtw),systolic dyssynchrony index(SDI)and Torsion.M-mode echocardiography was used to evaluate the aortic elastic parameters,including aortic strain(AS),aortic stiffness index(ASI),aortic compliance(AC),aortic distensibility(ADIS)and aortic coefficient of elasticity and pressure(AEp).Parameters described above were compared between the two groups.Spearman correlation analysis was used to estimate the correlation between left ventricular function and aortic elasticity in patients with essential hypertension.Results:Compared with the control group,GLS,GCS,GRS,AS,ADIS and AC were all decreased,while LVPtw,SDI,Torsion,ASI and AEp were all increased in the EH group,with statistically significant differences(all P<0.05).The results of correlation analysis indicated that LVPtw and Torsion were both negatively correlated with AS,ADIS and AC,while both were positively correlated with ASI and AEp(both P<0.05).SDI was negatively correlated with AS and ADIS,but positively correlated with ASI and AEp(both P<0.05).Conclusion:Threedimensional speckle tracking technique can be used to evaluate the changes of left ventricular systolic function in patients with essential hypertension.The increase of left ventricular torsional movement and the dyssynchrony of myocardial movement may be correlated with the decrease of ascending aorta elasticity.

关 键 词：三维斑点追踪技术 高血压 升主动脉弹性 左室功能 

分 类 号：R544.1[医药卫生—心血管疾病]