左心室压力-应变环对不同年龄正常成年人心肌做功的评价  

Evaluation of myocardial work in normal adults of varying ages by left ventricular pressure-strain loop

作　　者：胡萍 解翔[1] 伍婷婷[1] 姜凡[1] Hu Ping;Xie Xiang;Wu Tingting;Jiang Fan(Department of Ultrasound,the Second Affiliated Hospital of Anhui Medical University,Hefei 230601,China)

机构地区：[1]安徽医科大学第二附属医院超声科,合肥230601

出　　处：《中华医学超声杂志（电子版）》2023年第4期391-397,共7页Chinese Journal of Medical Ultrasound(Electronic Edition)

基　　金：安徽省高校自然科学研究重大项目(KJ2020ZD22)。

摘　　要：目的应用左心室压力-应变环(LV-PSL)评价不同年龄正常成年人心肌做功,并探讨其与年龄的关系。方法选取2021年7月至2021年9月在安徽医科大学第二附属医院健康体检的青年志愿者(18~45岁)、中年志愿者(46~64岁)和老年志愿者(≥65岁)各30名。采集常规超声参数,并通过LV-PSL获得左心室心肌应变及做功参数,包括左心室整体纵向应变(GLS)、整体做功指数(GWI)、整体有效功(GCW)、整体无效功(GWW)及整体做功效率(GWE),比较不同年龄组的差别。结果各年龄组正常成人GLS、GWI及GCW测值比较,差异无统计学意义(P均>0.05);GWW测值随年龄增长有增加趋势,老年组GWW测值较青年组和中年组明显增加,差异有统计学意义(P均<0.05);GWE测值随年龄增长有下降趋势,老年组GWE测值较青年组和中年组明显下降,差异有统计学意义(P均<0.05)。相关性分析:GWI与收缩压、GLS及左心室射血分数(LVEF)呈正相关(r=0.326、0.608、0.315,P均<0.05);GCW与收缩压、GLS及左心室射血分数(LVEF)呈正相关(r=0.308、0.488、0.219,P均<0.05);GWW与收缩压、年龄、A峰呈正相关(r=0.265、0.544、0.348,P均<0.05),与E峰、E/A、e′呈负相关(r=-0.256、-0.452、-0.324,P均<0.05);GWE与GLS、E峰、E/A、e´呈正相关(r=0.222、0.322、0.508、0.338,P均<0.05),与年龄、A峰呈负相关(r=-0.595,-0.350,P均<0.05)。结论无创心肌做功参数与传统超声左心室收缩、舒张功能参数均有显著相关性。随着年龄增长,GWW有增加趋势,GWE有下降趋势,临床中应用LV-PSL测得的心肌做功参数评价左心室功能时,应充分考虑年龄因素的影响。Objective To quantitatively evaluate myocardial work by left ventricular pressure-strain loop(LV-PSL)in normal adults of different ages and explore the relationship between myocardial work and age.Methods A total of 30 young volunteers(18-45 years old),30 middle-aged volunteers(46-64 years old),and 30 elderly volunteers(≥65 years old)who underwent physical examination at the Second Affiliated Hospital of Anhui Medical University from July 2021 to September 2021 were selected.Routine ultrasonic parameters were collected.LV-PSL was used to evaluate left ventricular myocardial work parameters,including left ventricular global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),global work waste(GWW),and global work efficiency(GWE).The differences in these parameters among the age groups were compared.Results There was no significant difference in GLS,GWI,or GCW among normal adults of different age groups(P>0.05 for all).However,GWW increased with increasing age,and it was significantly higher in the elderly group than in the young and middle-aged groups(P<0.05 for both),while GWE decreased with increasing age,and GWE in the elderly group was significantly lower than that in the young and middle-aged groups(P<0.05 for both).GWI was positively correlated with systolic blood pressure,GLS,and left ventricular ejection fraction(LVEF)(r=0.326,0.608,and 0.315,respectively,P<0.05 for all).GCW was also positively correlated with systolic blood pressure,GLS,and LVEF(r=0.308,0.488,and 0.219,respectively,P<0.05 for all).GWW was positively associated with systolic blood pressure,age,and late diastolic peak velocity(A)(r=0.265,0.544,and 0.348,respectively,P<0.05 for all)and negatively associated with early diastolic peak velocity(E),E/A,and early diastolic mitral annular motion velocity(e′)(r=-0.256,-0.452,and-0.324,respectively,P<0.05 for all).GWE was positively correlated with GLS,E,E/A,and e′(r=0.222,0.322,0.508,and 0.338,respectively,P<0.05 for all)and negatively correlated with age and A(r=-0.

关 键 词：左心室压力-应变环 心肌做功 超声心动图 心室功能 年龄 

分 类 号：R540.45[医药卫生—心血管疾病]