压力-应变环评价高血压左心室肥厚患者早期左心室功能障碍的研究  

Evaluation of Early Left Ventricular Dysfunction in Hypertension Patients with Left Ventricular Hypertrophy by Pressure-Strain Loop

作　　者：冷晨蕾 秦芸芸 蔡绮哲[1] 丁雪晏 林明明 金姗 吕秀章[1] Leng Chenlei;Qin Yunyun;Cai Qizhe;Ding Xueyan;Lin Mingming;Jin Shan;Lyu Xiuzhang(Department of Ultrasound Medicine,Beijing Chao-Yang Hospital,Capital Medical University,Beijing 100020,China)

机构地区：[1]首都医科大学附属北京朝阳医院超声医学科,北京市100020

出　　处：《中国超声医学杂志》2023年第9期1008-1011,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的应用无创左心室压力-应变环评价高血压左心室肥厚(LVH)患者的心肌做功,探索其早期心功能受损情况。方法前瞻性纳入64例原发性高血压患者和32例健康志愿者。根据左心室质量指数(LVMI)将高血压患者分为左心室肥厚组(LVH组)和非肥厚组(NLVH组)。测量并比较各组常规参数、左心室整体长轴应变(GLS)、机械离散度(MD)及心肌做功参数,分析心肌做功参数与LVMI、常规参数、GLS、MD及肱动脉收缩压的相关性。结果(1)LVH组较对照组MD、整体有效功(GCW)、整体无效功(GWW)增加,GLS绝对值、整体做功效率(GWE)减低,较NLVH组MD增加,GLS绝对值、整体做功指数(GWI)、GWE减低(P<0.05)。(2)高血压患者GWI、GCW分别与收缩压(SBP)呈正相关,与GLS、LVMI呈负相关;GWW与SBP、GLS、MD呈正相关;GWE与LVMI、SBP、GLS、MD呈负相关(P<0.05)。结论左心室心肌做功参数可灵敏识别高血压左心室肥厚患者早期左心室功能受损,为临床评估提供更多参考信息。Objective To evaluate myocardial work in hypertension patients with left ventricular hypertrophy(LVH)by left ventricular pressure-strain loop,and to explore the early cardiac dysfunction.Methods 64 patients with primary hypertension and 32 healthy volunteers were prospectively included.Hypertensive patients were divided into left ventricular hypertrophy group(LVH group)and non-hypertrophic group(NLVH group)based on left ventricular mass index(LVMI).Conventional parameters,left ventricular global longitudinal strain(GLS),mechanical dispersion(MD)and myocardial work parameters of the three groups were collected and compared.And the correlation between myocardial work parameters and LVMI,conventional parameters,GLS,MD and brachial artery systolic pressure was analyzed.Results(1)Compared with control group,MD,global constructive work(GCW),and global wasted work(GWW)were increased in LVH group,while absolute values of GLS and global work efficiency(GWE)were decreased.Compared with NLVH group,MD was increased,while the absolute value of GLS,global work index(GWI),and GWE were decreased(P0.05).(2)In hypertension patients,GWI and GCW were positively correlated with systolic blood pressure(SBP),and negatively correlated with GLS and LVMI;GWW was positively correlated with SBP,GLS,and MD;GWE was negatively correlated with LVMI,SBP,GLS,and MD(P0.05).Conclusions Myocardial work parameters can sensitively identify early left ventricular dysfunction in hypertension patients with LVH,providing more information for clinical evaluation.

关 键 词：高血压 左心室肥厚 压力-应变环 心肌做功 

分 类 号：R445.1[医药卫生—影像医学与核医学] R544.1[医药卫生—诊断学]