应变率显像对高血压患者左室舒张功能的评价

Left ventricular diastolic function in patients with hypertension evaluated by strain rate imaging

目的探讨应变率显像(SRI)技术评价高血压患者左室舒张功能的临床意义。方法获取25例高血压病人和20例正常人二腔观、三腔观和四腔观应变率显像及组织多普勒图像,分析左室各节段心肌舒张期应变率曲线和二尖瓣环运动速度曲线,计算左室各节段应变率(SR)、平均峰值应变率(mSR)、左室平均应变率传播速度(PVS)和二尖瓣环平均运动速度(V)。常规测量二尖瓣口E、A、E/A值。结果与正常组相比,高血压组舒张早期V、SR均有明显降低,舒张早期和舒张晚期PVS均降低。舒张早期SR与V呈高度正相关。舒张早期除后间隔基底段和侧壁基底段外其余相应节段心肌SR均有显著降低。结论SRI是一项准确定量评价高血压患者左室整体和局部舒张功能的无创性新技术。

Objective To evaluate the clinical significance of left ventricular diastolic function in patients with hypertension by strain rate imaging （SRI）. Methods Doppler echocardiography, Doppler tissue imaging and SRI were performed on hypertension patients （n--25） and healthy subjects （n 20） at two-chamber, three-chamber and four-chamber views. Early diastolic and atrial contraction velocities at mitral annular （V）, strain rate （SR）, mean strain rate （mSR） and strain rate propagation （PVS） were measured at each middle and base of the ventricule. Transmitral flow velocities （E, A） were also measured and E/A ratio were calculated. Results Compared with healthy subjects, there was a significant reduction in early diastolic veloclties of the mitral annulus, PVS and mSR ih patients. PVS during atrial systole phase was considerably lower in the patients group. There was a significant correlation in early diastole between V and SR. Compared with the healthy subjects, patients had appreciably lower SR on all of the walls in early diastole, except the basal of the post septum and lateral ones. Conclusion The study demonstrated that SRI could assess the left ventricular global and regional diastolic functions in patients with hypertension. SRI is a valuable quantitative noninvasive technique.