右心室游离壁纵向应变与肺动脉收缩压比值用于评价肥厚型心肌病患者右心室收缩功能  

Ratio of right ventricular free wall longitudinal strain to pulmonary artery systolic pressure for evaluating right ventricular systolic function in patients with hypertrophic cardiomyopathy

作　　者：刘冉冉[1] 陈晓菲 唐国璋[1] 马晓[1] 江佳楠 付秀秀[1] LIU Ranran;CHEN Xiaofei;TANG Guozhang;MA Xiao;JIANG Jianan;FU Xiuxiu(Department of Cardiac Ultrasound,the Affiliated Hospital of Qingdao University,Qingdao 266000,China)

机构地区：[1]青岛大学附属医院心脏超声科,山东青岛266000

出　　处：《中国介入影像与治疗学》2025年第2期97-101,共5页Chinese Journal of Interventional Imaging and Therapy

摘　　要：目的观察右心室游离壁纵向应变(RVFWLS)与肺动脉收缩压(PASP)比值(RVFWLS/PASP)用于评价肥厚型心肌病(HCM)患者右心室(RV)收缩功能的价值。方法回顾性纳入52例HCM患者,根据RVFWLS/PASP中位数将其分为A(RVFWLS/PASP≤0.75,n=26)、B组(RVFWLS/PASP>0.75,n=26),同期招募26名健康成年人作为对照组;获取常规超声心动图与斑点追踪成像(STI)参数并进行组间比较。采用线性回归分析RVFWLS/PASP与各参数间的相关性。结果A、B组左心室射血分数(LVEF)、RV间隔纵向应变(RVSepLS)、RVFWLS、RV收缩末期容积指数(RVEDVi)、RV每搏量(RVSV)、RV面积变化分数(RVFAC)及左心室整体纵向应变(LVGLS)均低于,而二尖瓣口舒张期E峰血流速度与二尖瓣间隔瓣环舒张早期速度比值(E/e′)均高于对照组(校正P均<0.05)。相比对照组及B组,A组PASP较高而RV射血分数(RVEF)较低(校正P均<0.05);相比B组,A组RVFWLS及LVGLS均较低(校正P均<0.05)。线性回归分析显示,RVSepLS及RVEF与RVFWLS/PASP呈独立线性相关(P均<0.05)。结论利用RVFWLS/PASP可早期监测HCM患者RV收缩功能变化。Objective To observe the value of right ventricular free wall longitudinal strain(RVFWLS)to pulmonary artery systolic pressure(PASP)ratio(RVFWLS/PASP)for evaluating systolic function of right ventricle(RV)in patients with hypertrophic cardiomyopathy(HCM).Methods Fifty-two HCM patients were retrospectively collected and divided into group A(RVFWLS/PASP≤0.75,n=26)and B(RVFWLS/PASP>0.75,n=26)according to median RVFWLS/PASP.Meanwhile,26 healthy individuals were included as control group.Parameters of echocardiography and speckle tracking imaging(STI)were obtained and compared among 3 groups.The correlations of RVFWLS/PASP and other parameters were analyzed with linear regression.Results In group A and B,left ventricular ejection fraction(LVEF),RV septal longitudinal strain(RVSepLS),RVFWLS,RV end-diastolic volume index(RVEDVi),RV stroke volume(RVSV),RV fractional area change(RVFAC)and left ventricular global longitudinal strain(LVGLS)were all lower,while the ratio of peak E blood flow velocity at mitral orifice diastole to early mitral intervalal annulus diastole velocity(E/e′)were higher than those in control group(all adjusted P<0.05).Compared with group B and control group,group A had higher PASP but lower RV ejection fraction(RVEF)(all adjusted P<0.05).Furthermore,RVFWLS and LVGLS were both lower in group A than in group B(both adjusted P<0.05).Linear regression analysis showed that RVSepLS and RVEF were independently linearly related to RVFWLS/PASP(both P<0.05).Conclusion RVFWLS/PASP could be used to monitor changes of RV systoic function in HCM patients at early stage.

关 键 词：心肌病 肥厚型 肺循环 血流动力学 超声心动描记术 

分 类 号：R542.2[医药卫生—心血管疾病] R540.45[医药卫生—内科学]