心电模态联合二维斑点追踪技术评价业余马拉松跑者左心室收缩功能  

Evaluation of left ventricular systolic function in amateur Marathon runners through ECG mode combined with two-dimensional speckle tracking technique

作　　者：葛志祥[1] 冯秀 杨盼 江姝 徐敏[1] 邢伟[2] GE Zhixiang;FENG Xiu;YANG Pan;JIANG Shu;XU Min;XING Wei(Echocardiography Room,The Third Affiliated Hospital of Soochow University,The First People's Hospital of Changzhou,Changzhou,Jiangsu,213100,China;Imaging Department,The Third Affiliated Hospital of Soochow University,The First People's Hospital of Changzhou,Changzhou,Jiangsu,213100,China)

机构地区：[1]苏州大学附属第三医院(常州市第一人民医院)心超室,江苏常州213100 [2]苏州大学附属第三医院(常州市第一人民医院)影像科

出　　处：《临床心血管病杂志》2025年第3期207-212,共6页Journal of Clinical Cardiology

基　　金：常州市卫健委科技项目(青年人才科技项目)(No:QN202208);常州市“十四五”卫生健康高层次人才培养工程(No:常财社[109]号)。

摘　　要：目的:探讨业余马拉松跑者心电图SV1+RV5水平与左心室整体纵向应变(global longitudinal strain,GLS)的相关性,评价业余马拉松跑者早期左心室收缩功能。方法:选取2022年9月—2023年9月于常州市第一人民医院超声心动室检查的102位业余马拉松跑者,收集及记录临床资料,采集心电图检查资料,记录受检者SV1+RV5、RaVL+SV3,获取室间隔厚度(interventricular septal thickness,IVST)、左心室舒张末期内径(left ventricular end-diastolic diameter,LVEDD)、左心室后壁厚度(left ventricular posterior wall thickness,LVPWT)、左心室质量指数(left ventricular mass index,LVMI)、左心室射血分数(left ventricular ejection fraction,LVEF)。应用二维斑点追踪成像(two-dimensional speckle tracking imaging,2D-STI)技术获取所有受检者的左心室整体纵向应变值(global longitudinal strain,GLS)。102位业余马拉松跑者按心电图SV1+RV5值的从小到大排列,再按入组人数三分位分组,其中低位组34例、中位组33例、高位组35例。比较各组一般临床资料。采用线性回归分析各参数与GLS的关系。使用广义相加模型(generalized additive model,GAM)分析SV1+RV5与GLS的关系。结果:3组间性别、吸烟史、饮酒史、高血压史、体表面积(body surface area,BSA)、LVMI、SV1+RV5、LVEDD、IVST、LVPWT、GLS均差异有统计学意义(均P<0.05)。线性回归分析显示,SV1+RV5与GLS独立相关,且随着SV1+RV5的升高,GLS也逐渐升高(P<0.05)。曲线拟合显示SV1+RV5与GLS呈现正相关。结论:马拉松跑者的左心室GLS与SV1+RV5独立相关,且随着SV1+RV5的升高,GLS也逐渐升高。将两者结合可早期发现左心室收缩功能的异常,这对于预防不良心血管病事件的发生有积极的作用。Objective To investigate the correlation between the level of SV1+RV5 in electrocardiogram and the global longitudinal strain(GLS)of left ventricle,and evaluate early left ventricular systolic function in amateur Marathon runners.Methods A total of 102 amateur Marathon runners were selected for echocardiography examination in The First People's Hospital of Changzhou from December 2019 to December 2022.Clinical data were collected and recorded,ECG data were collected,and the value of SV1+RV5,RaVL+SV3 of the subjects were recorded.Interventricular septal thickness(IVST),left ventricular end-diastolic diameter(LVEDD),left ventricular posterior wall thickness(LVPWT),left ventricular mass index(LVMI),left ventricular ejection fraction(LVEF).Two-dimensional speckle tracking imaging(2D-STI)technique was applied to obtain global longitudinal strain(GLS).Divide the 102 amateur marathon runners into tertiles based on the ECG SV1+RV5 value from the smallest to the largest,and then according to the number of participants,with low group of 34,middle group of 33,high group of 35.General data among the three groups were compared.The relationship between each parameter and GLS was analyzed by linear regression.Generalized additive model(GAM)was used to analyze the relationship between GLS and SV1+RV5.Results There were statistically significant differences among the three groups in gender,total horse participation times,best half-horse performance,smoking history,drinking history,hypertension history,systolic blood pressure,BSA,LVMI,SV1+RV5,LVEDD,IVST,LVPWT,and GLS(all P<0.05).Linear regression analysis showed that there was an independent correlation between SV1+RV5 and GLS,and with the increase of SV1+RV5,the GLS value also gradually increased(P<0.05).Curve fitting showed that SV1+RV5 was positively correlated with GLS.Conclusion The left ventricular GLS of Marathon runners is independently correlated with SV1+RV5,and with the increase of SV1+RV5,the GLS value also gradually increases.The combination of the two can detect the

关 键 词：马拉松 心电图 二维斑点追踪成像 超声心动图 左心室收缩功能 左心室整体纵向应变 

分 类 号：R445.1[医药卫生—影像医学与核医学]