无创心肌做功技术评估重度三尖瓣反流状态下左心室收缩功能的研究  

Study of Noninvasive Myocardial Work Technology in the Evaluation of Left Ventricular Systolic Function with Severe Tricuspid Regurgitation

作　　者：陈涵 冯德喜 CHEN Han;FENG Dexi(Graduate School,Baotou Medical College,Inner Mongolia University of Science and Technology,Baotou 014040 China;Department of Ultrasonic Medicine,Inner Mongolia Autonomous Region People's Hospital,Hohhot 010017 China)

机构地区：[1]内蒙古科技大学包头医学院研究生院,内蒙古包头014040 [2]内蒙古自治区人民医院超声医学科,呼和浩特010017

出　　处：《内蒙古医学杂志》2024年第5期553-557,共5页Inner Mongolia Medical Journal

基　　金：2022年度自治区卫生健康科技计划项目(编号:202201019)。

摘　　要：目的利用超声心动图无创心肌做功技术探究重度三尖瓣反流状态下左心室收缩功能的改变及无创心肌做功技术对于评估重度三尖瓣反流患者左心室收缩功能的效果。方法选择30例重度三尖瓣反流患者作为病例组;同期18例年龄、性别等与病例组相匹配,经常规超心动图检查三尖瓣反流缩流颈宽度(VCW)≤3 mm且肺动脉收缩压(PASP)≤30 mm Hg的轻度三尖瓣反流(生理性)体检者作为对照组。使用GE Vivid E95彩色多普勒超声诊断仪及GE Echo PAC超声分析工作站进行图像及常规左心室收缩功能参数、心肌做功参数采集并进行参数分析。结果病例组PASP、左心房前后径、VCW较对照组明显升高(P<0.01);病例组LVEF与对照组相比减低(P<0.01);病例组GLS绝对值、GWI、GCW、GWE明显减低(P<0.01),GWW明显高于对照组(P<0.01),左室GWE、GWI、GCW与VCW呈负相关(P<0.05),GWW与VCW呈正相关(P<0.05);左室GWE、GWI、GCW与GLS呈负相关(P<0.01),GWW与GLS呈正相关(P<0.05)。结论无创心肌做功技术可以准确评估重度三尖瓣反流患者左心室心肌做功参数、收缩功能改变,证实重度三尖瓣反流患者左心室收缩功能早期已出现明显改变。Objective To explore changes in left ventricular systolic function in severe tricuspid regurgitation(TR)using noninvasive myocardial work technology via echocardiography and evaluate the effectiveness of this technology in assessing left ventricular systolic function in patients with severe TR.Methods Thirty patients with severe TR were selected as the case group,and 18 individuals with mild TR(physiological),matched for age and gender,with tricuspid regurgitation jet width(VCW)≤3 mm and pulmonary artery systolic pressure(PASP)≤30 mm Hg were chosen as the control group.Images and conventional left ventricular systolic function parameters,along with myocardial work parameters,were collected and analyzed using the GE Vivid E95 color Doppler ultrasound diagnostic system and GE Echo PAC ultrasound analysis workstation.Results In the case group,PASP,left atrial anteroposterior diameter,and VCW were significantly higher than those in the control group(P<0.01).The left ventricular ejection fraction(LVEF)in the case group was lower compared to the control group(P<0.01).The absolute value of global longitudinal strain(GLS),global work index(GWI),global constructive work(GCW),and global work efficiency(GWE)were significantly decreased(P<0.01),while global wasted work(GWW)was significantly higher in the case group(P<0.01).Left ventricular GWE,GWI,GCW were negatively correlated with VCW(P<0.05),and GWW was positively correlated with VCW(P<0.05);left ventricular GWE,GWI,GCW were negatively correlated with GLS(P<0.01),and GWW was positively correlated with GLS(P<0.05).Conclusion Noninvasive myocardial work technology can accurately assess changes in left ventricular myocardial work parameters and systolic function in patients with severe TR,confirming early significant changes in left ventricular systolic function in these patients.

关 键 词：左心室收缩功能 无创心肌做功技术 三尖瓣反流 

分 类 号：R445.1[医药卫生—影像医学与核医学] R542.5[医药卫生—诊断学]