四维左房定量分析技术评价隐匿性未控制高血压患者左房结构和功能的临床价值  

Clinical value of four-dimensional automatic left atrial quantitative technology in evaluating left atrium structure and function in patients with masked uncontrolled hypertension

作　　者：李颖[1] 孙雪纯 赵含章[1] 李静[1] 张慧慧 丁明岩[1] LI Ying;SUN Xuechun;ZHAO Hanzhang;LI Jing;ZHANG Huihui;DING Mingyan(Department of Cardiac Function,the People’s Hospital of Liaoning Province,Shenyang 110016,China)

机构地区：[1]辽宁省人民医院心功能科,沈阳市110016

出　　处：《临床超声医学杂志》2024年第8期684-689,共6页Journal of Clinical Ultrasound in Medicine

摘　　要：目的探讨四维左房定量分析技术(4D-Auto-LAQ)评价隐匿性未控制高血压(MUHT)患者左房结构和功能的临床应用价值。方法选取于我院行24 h动态血压监测的隐匿性高血压患者71例,其中MUHT者34例(MUHT组),血压控制良好者37例(WCHT组)。应用常规超声心动图获取左房内径(LAD)、室间隔厚度(IVST)、左室后壁厚度(LVPWT)、左室舒张末容积(LVEDV)、左室射血分数(LVEF)、二尖瓣口舒张早期和晚期血流速度(E和A)、左室侧壁运动速度(Lat e’)及室间隔运动速度(Sep e’),计算Lat e’和Sep e’的平均值(e’)和E/e’;4D-Auto-LAQ获取左房容积参数和左房应变参数,其中左房容积参数包括左房最大容积指数(LAVImax)、左房收缩前容积指数(LAVIpreA)、左房最小容积指数(LAVImin)、左房总射血分数(LAEF)、左房被动射血分数(LApEF)、左房主动射血分数(LAaEF),左房应变参数包括左房储备期应变(LASr)、左房管道期应变(LAScd)、左房收缩期应变(LASct);比较两组上述各参数的差异;分析LASr、LAScd、LASct与E/e’的相关性。结果与WCHT组比较,MUHT组Lat e’、Sep e’、e’均减低,E/e’增加,差异均有统计学意义(均P<0.05);两组LAD、IVST、LVPWT、LVEDV、LVEF、E、A比较差异均无统计学意义。与WCHT组比较,MUHT组LAVImax、LAVIpreA、LAVImin、LAaEF均增加,LApEF、LASr、LAScd、LASct均减低,差异均有统计学意义(均P<0.05)。相关性分析显示,LASr与E/e’呈正相关(r=0.393,P<0.001),LAScd、LASct与E/e’均无明显相关性。结论4D-Auto-LAQ可早期发现MUHT患者左房结构和功能变化,具有一定的临床应用价值。Objective To explore the clinical application value of four-dimensional automatic left atrial quantification technology(4D-Auto-LAQ)in evaluating left atrial structure and function in patients with masked uncontrolled hypertension(MUHT).Methods A total of 71 patients with masked hypertension who underwent 24 h ambulatory blood pressure monitoring in our hospital were selected,including 34 patients with MUHT(MUHT group)and 37 patients with wellcontrolled hypertension(WCHT group).Conventional echocardiography was used to obtain the left atrial diameter(LAD),interventricular septal thickness(IVST),left ventricular posterior wall thickness(LVPWT),left ventricular end-diastolic volume(LVEDV),left ventricular ejection fraction(LVEF),mitral orifice early and late diastolic blood flow velocity(E,A),left ventricular wall motion velocity(Lat e’)and ventricular septal motion velocity(Sep e’),the average of Lat e’and Sep e’(e’)and E/e’were calculated.4D-Auto-LAQ was used to obtain left atrial volume parameters and left atrial strain parameters,including left atrial maximum volume index(LAVImax),left atrial pre-systolic volume index(LAVIpreA),left atrial minimum volume index(LAVImin),left atrial total ejection fraction(LAEF),left atrial passive ejection fraction(LApEF),left atrial active ejection fraction(LAaEF),left atrial reserve phase strain(LASr),left atrial conduit phase strain(LAScd)and left atrial systolic strain(LASct).The differences of the above parameters between the two groups were compared.The correlation between LASr,LAScd,LASct and E/e’were analyzed.Results Compared with WCHT group,Lat e’,Sep e’and e’in MUHT group were decreased,while E/e’was increased,and the differences were statistically significant(all P<0.05).There were no significant differences in LAD,IVST,LVPWT,LVEDV,LVEF,E and A between MUHT group and WCHT group.Compared with WCHT group,LAVImax,LAVIpreA,LAVImin and LAaEF in MUHT group were increased,while LApEF,LASr,LAScd and LASct were decreased,and the differences were statistic

关 键 词：超声心动描记术 四维左房定量分析技术 隐匿性未控制高血压 心房功能 左 

分 类 号：R540.45[医药卫生—心血管疾病] R544.1[医药卫生—内科学]