斑点追踪显像技术与实时三平面组织同步显像技术评价不同构型高血压病患者左室心肌收缩功能

Assessment of left ventricular systolic function in essential hypertension patients with different left ventricular patterns using speckle tracking imaging and real-time three-plane tissue synchronization imaging

目的探讨斑点追踪显像(STI)技术与实时三平面组织同步显像(RT-3PE)技术评价不同构型高血压患者左室收缩功能的临床价值。方法收集60例高血压病患者(高血压病组)和40例正常人(正常组)的临床资料,根据左室质量指数(LVMI)和相对室壁厚度(RWT)将高血压患者分为正常构型组(LVN组)和左室重构组(LVR组)。应用STI技术获得左室6个壁基底段、中间段、心尖段的收缩期峰值应变(SLs)及应变率(SrLs),并计算平均峰值应变及应变率(mSLs、mSrLs);用RT-3PE TSI技术测量左心室前壁、侧壁、后壁、下壁和室间隔的基底段和中间段等12个心肌节段的收缩达峰时间(Tp),计算Tp平均值(mTp)和标准差(sdTP),进行分析比较。结果与正常组比较,LVN组及LVR组SLs、mSLs、SrLs及mSrLs降低,LVN组、LVR组mTp延长,sdTp增大,差异有统计学意义(P<0.05),与LVN组比较,LVR组SLs、mSLs、SrLs及mSrLs减低,LVR组mTp和sdTp延长、增大,差异有统计学意义(P<0.05)。结论 STI和RT-3PE TSI技术能够准确地测量左室心肌的收缩达峰时间、应变及应变率,为临床提供了一个更敏感、简便、可靠的指标评价原发性高血压患者左室心肌功能的方法。

Objective To explore the left ventricular systolic function in essential hypertension patients with different left ventricular patterns by speckle tracking imaging（STI） and real-time three-plane（RT-3PE） tissue synchronization imaging（TSI）. Methods Sixty patients with essential hypertension and forty healthy subjects were detected with their clinical characteristics collected. According to level of LV mass index and relative wall thickness, 60 patients with hypertension were divided into patterns of normal geometric LV （ LVN ） and remodeling LV （ LVR ）. Systolic strain（SLs） and systolic strain rate （SrLs）at middle, basal and apical ventricule were measured using STI, then the average of strain （mSLs） and strain rate （mSrLs） in the left ventricular were calculated. The time to peak systolic velocity（Tp） of 12 segments such as basal and middle segments of anterior, lateral, posterior, inferior, and septal walls were measured by RT-3PE TSI. Stand deviation of Tp（sdTp） and mean value of Tp（mTp）were calculated. Results Compared with control group, SLs, mSLs, SrLs and mSrLs of LVN and LVR were reduced, while mTp was longer and sdTp was increased （P 〈 0.05）. Compared with LVN, SLs, mSLs, SrLs and mSrLs of LVR were reduced, while mTp and sdTp of LVR were significantly longer and increased （P 〈 0. 05 ）. Conclusion RT- 3PE TSI and STI can properly quantify time to peak systolic velocity, systolic strain and strain rate on walls of left ventricular in patients with essential hypertension, which provides a more sensitive, simple and reliable method to evaluate left ventricular myocardial function of essential hypertension patients.