左室压力应变环技术评估瓣膜功能正常的二叶式主动脉瓣患者亚临床左室心肌功能  

Evaluation of subclinical left ventricular myocardial function by the left ventricular pressure-strain looptechnique in patients with bicuspid aortic valves with normal valve function

作　　者：吴楠[1] 王栎茗 王莉莉 纳丽莎 WU Nan;WANG Liming;WANG Lili;NA Lisha(Ultrasonic Cardiology Center,General Hospital of Ningxia Medical University,Yinchuan 750004,China;Heart Center,General Hospital of Ningxia Medical University,Yinchuan 750004,China)

机构地区：[1]宁夏医科大学,宁夏银川750004 [2]宁夏医科大学总医院心脏中心,宁夏银川750004

出　　处：《宁夏医学杂志》2024年第4期299-303,共5页Ningxia Medical Journal

基　　金：宁夏自然科学基金项目(2023AAC03635)。

摘　　要：目的探讨超声心动图压力应变环技术(PSL)技术评价瓣膜功能正常的二叶式主动脉瓣(BAV)患者亚临床左室心肌功能。方法收集二叶式主动脉瓣患者作为病例组(BAV组,n=40),另选取主动脉瓣三叶瓣(TAV)的健康志愿者为对照组(TAV组,n=40)。各组获取2D-TTE参数,包括LVDd、LVDs、IVSd、LVpWd、MpA、LAD、LVEF,计算E/A、E/e′值。应用2D-STI技术获取左室GLS,应用PSL技术获取心肌做功参数,包括GWI、GCW、GWW及GWE。计算升主动脉AosI、Aortic Strain和AODSI。比较2组之间的差异,分析BAV组左室心肌做功参数与升主动脉Aortic Stain、AosI、AODSI参数的相关性。结果2D-TTE参数:BAV组较对照组E/A和E/e′参数均有所下降(P<0.05);BAV组较对照组GLS(绝对值)、GWI、GCW和GWE下降,GWW升高,2组比较差异有统计学意义(P<0.05);BAV组Aortic Stain、AODSI值较TAV组下降,AosI值较TAV组增加,2组比较差异有统计学意义(P<0.05)。BAV组中GWI、GCW与Aortic Stain、AODSI呈正相关(r分别为0.716、0.395、0.265、0.359,P<0.05)。结论PSL技术能够早期检出瓣膜功能正常的BAV患者亚临床左室心肌损害;瓣膜功能正常的BAV患者早期亚临床左室心肌损害可能与升主动脉结构或功能有关。Objective To explore the evaluation of subclinical left ventricular myocardial function in BAV patients with normal valve function by using the echocardiographic PSL technology.Methods 40 patients with bicuspid aortic valves were collected as the BAV group and 40 healthy volunteers with trileaflet aortic valves were selected as the TAV group.2D-TTE parameters including LVDd,LVDs,IVSd,LVPWd,MPA,LAD and LVEF were obtained in each group,and E/A and E/e′values were calculated.2D-STI technique was applied to obtain LV GLS.The PSL technique was applied to obtain myocardial work parameters,including GWI,GCW,GWW and GWE.Ascending aortic AosI,Aortic Strain and AODSI were calculated.The difference between the two groups was compared.The correlation between the LV myocardial work parameters in the BAV group and the Aortic Stain,AosI and AODSI parameters in the ascending aortic were analyzed.Results 2D-TTE parameters:E/A and E/e′parameters decreased in the BAV group compared with the control group,and the differences were statistically significant(P<0.05).Compared with the TAV group,GLS(absolute value),GWI,GCW and GWE decreased and GWW increased in the BAV group(P<0.05).Compared with the TAV group,Aortic Stain and AODSI values decreased in BAV group and AosI values increased(P<0.05).Correlation analysis showed that there was a significant positive correlation between GWI,GCW and Aortic Stain,AODSI in the BAV group(r=0.716,0.395,0.265,0.359,P<0.05).Conclusion PSL technology can early detect subclinical LV myocardial damage in BAV patients with normal valve function at an early stage.Early subclinical LV myocardial damage in BAV patients with normal valve function may be related to the structure or function of the ascending aorta.

关 键 词：二叶式主动脉瓣 左室压力应变环技术 心肌做功 主动脉瓣 

分 类 号：R542.5[医药卫生—心血管疾病]