三维超声心肌应变参数对慢性心力衰竭左心室重构的预测价值

The predictive value of three-dimensional ultrasound myocardial strain parameters for left ventricular remodeling in chronic heart failure

目的:探究三维超声的心肌应变相关参数对慢性心力衰竭(CHF)左心室重构方面预测的价值。方法 :挑选我院2021年6月-2022年6月治疗的65例CHF患者为此次试验的对象,均接受三维超声检查。按照是否出现了左心室重构分为2组(发生组26例,未发生组39例)。收集患者临床资料,分析心肌应变参数对CHF发生左心室重构的预测价值。结果:发生组病程长于未发生组,左心室舒张末期容积指数(LVEDV)全部较未发生组高,左心室射血分数(LVEF)全部较未发生组低(P<0.05)。发生组左室整体的纵向方面应变(GLS)、整体的环周方面应变(GCS)、整体的径向方面应变(GRS)、整体的面积方面应变(GAS)大于未发生组(P<0.05)。Logistic回归分析显示,LVEF、LVEDV、GLS、GCS、GRS、GAS是影响患者发生左心室重构的危险因素(P<0.05)。经受试者的工作特征曲线(ROC)结果可以观察到,GLS、GCS、GRS、GAS联合诊断CHF患者发生左心室重构曲线下面积(AUC)、灵敏度、特异度、准确度分别为0.893、84.6%、89.7%、87.2%,均高于单项诊断效能(P<0.05)。结论:GLS、GCS、GRS、GAS联合检测对CHF左心室重构具有良好的预测价值,可用于临床指导开展个性化治疗,预防左心室重构发生。

Objective:To explore the predictive value of three-dimensional ultrasound myocardial strain parameters on left ventricular remodeling in chronic heart failure(CHF).Methods:Sixty-five CHF patients admitted to our hospital from June 2021 to June 2022 were selected as the study subjects,all of them underwent three-dimensional ultrasound examination.Ac-cording to whether left ventricular remodeling occurs,they were divided into occurrence group(26 cases)and non-occurrence group(39 cases).Clinical data of patients are collected to analyze the predictive value of myocardial strain parameters for left ventricular remodeling in CHF.Result:The duration of the disease in the occurrence group was longer than that in the non-occurrence group,and the left ventricular end diastolic volume index(LVEDV)was higher than that in the non-occurrence group.The left ventricular ejection fraction(LVEF)was lower than that in the non-occurrence group(P<0.05).The left ventricu-lar global longitudinal strain(GLS),global circumferential strain(GCS),global radial strain(GRS),and global area strain(GAS)in the occurrence group were higher than those in the non-occurrence group(P<0.05).Logistic regression analysis showed that LVEF,LVEDV,CLS,GCS,GRS,GAS were risk factors for left ventricular remodeling in patients(P<0.05).The analysis of the receiver operating characteristic curve(ROC)showed that the area under the left ventricular remodeling curve(AUC),sensitivity,specificity,and accuracy of the combined diagnosis of GLS,GCS,GRS,and GAS in patients with CHF were 0.893,84.6%,89.7%,and 87.2%,respectively,which were higher than the single diagnostic efficacy(P<0.05).Conclusion:The combined de-tection of GLS,GCS,GRS,and GAS has good predictive value for left ventricular remodeling in CHE,and can be used to guide personalized treatment and prevent left ventricular remodeling in clinical practice.