负荷超声心动图评价正常成年人左心室心肌做功的性别差异  

Evaluation of Gender Differences in Myocardial Work of Adults by Treadmill Exercise Stress Echocardiography

作　　者：黄栎为 丁戈琦 张红梅[1] 张清凤[1] 邓燕[1] 尹立雪[1] 王胰[1] Huang Liwei;Ding Geqi;Zhang Hongmei;Zhang Qingfeng;Deng Yan;Yin Lixue;Wang Yi(Department of Cardiovascular Ultrasound and Non-invasive Cardiology,Ultrasound in Cardiac Electrophysiology and Biomechanics Key Laboratory of Sichuan Province,Sichuan Provincial People's Hospital,University of Electronic Science and Technology of China,Chengdu,Sichuan 610072,China)

机构地区：[1]四川省医学科学院·四川省人民医院(电子科技大学附属医院)心血管超声及心功能科,超声心脏电生理学与生物力学四川省重点实验室,成都市610072

出　　处：《中国超声医学杂志》2024年第3期301-304,共4页Chinese Journal of Ultrasound in Medicine

摘　　要：目的 运用压力-应变环(PSL)评价静息和负荷状态下整体和节段心肌做功的性别差异。方法 选取127例健康成年志愿者进行平板运动负荷超声心动图(SE)检查。运用PSL评估心肌做功,计算整体做功指数(GWI)、整体有效做功(GCW)、整体无效做功(GWW)和整体做功效率(GWE)。分析不同性别间整体和节段心肌做功的差异。结果 负荷后整体及节段做功指数均增加。静息时男女间整体做功差异无统计学意义(P>0.05),负荷后女性GWE较高(P<0.05)。静息和负荷状态下均为心尖做功指数(WI)最高。静息时男女间心尖WI差异无统计学意义(P>0.05),负荷后男性心尖WI较高(P<0.05)。静息时GWI同一观察者内变异性的ICC为0.92,负荷后为0.89;静息时GWI不同观察者间变异性的ICC为0.91,负荷后为0.87。结论 在静息和负荷状态下,心肌做功受性别的影响均较小。负荷状态下PSL评估心肌做功一致性和可重复性较好,具有潜在的临床应用价值。Objective Pressure-strain loop(PSL)was used to evaluate the gender difference of global and segmental myocardial work at rest and after exercise.Methods A total of 127 healthy volunteers who underwent treadmill exercise stress echocardiography were collected.PSL was used to assess global work index(GWI),global constructive work(GCW),global wasted work(GWW)and global work efficiency(GWE).The gender difference was analyzed.Results The global and segmental myocardial work parameters of all adults were increased after exercise.There was no significant difference of global parameters between sexes at rest(P>0.05),GWE was significantly higher in women at load(P<0.05).Apical myocardial workindex(WI) was highest at rest and at load.There was no significant difference of apical WI between genders at rest(P>0.05).Apical WI was significantly higher in men at load(P<0.05).The inter-observer variability of interclass correlation coefficient(ICC) on GWI was 0.92 at rest and 0.89 at load.The intra-observer variability of ICC on GWI was 0.91 at rest and 0.87 at load.Conclusions Myocardial work is less affected by gender at rest and at load.PSL has good consistency and reproducibility in assessing myocardial work at load,which has potential clinical value.

关 键 词：压力-应变环 平板运动负荷 心肌做功 负荷超声心动图 左心室 

分 类 号：R540.45[医药卫生—心血管疾病]