不同构型高血压患者左室长轴收缩功能的应变率评价

Strain rate evaluation of left ventrical long-axis systolic function in essential hypertension patients with different left ventricular patterns

目的:探讨左心室收缩期应变率与射血分数的关系,评价不同左室构型的原发性高血压患者左室长轴收缩功能的临床价值。方法:研究对象为55例高血压患者和25例健康人,应用常规二维及M型超声心动图计算左室重量指数(LVMI)和相对室壁厚度(RWT)。根据LVMI和RWT将高血压病分为左室正常构型(LVN)和左室重构(LVR)两组。每例病人采用应变率成像法测量各室壁中间段和基底段的收缩期应变率,Simpson’s法计算射血分数。结果:不同构型组各室壁收缩期应变率的平均值与射血分数相关性良好(相关系数分别为r1=-0.82,r2=-0.84和r3=-0.94,P<0.001)。收缩期应变率在3组之间均有显著性差异(P值均<0.05)。射血分数在高血压LVR与正常组和高血压LVN组之间有显著性差异(P值均<0.05),而在正常人组和高血压LVN组之间没有显著性差异(P>0.05)。结论:应变率成像为临床提供了一个敏感、简便而可靠的描述原发性高血压患者心肌收缩功能的指标。

Objective： To assess the ability of strain rate imaging for assessment of left ventrical systolic function and to explore the relationship among left ventricular（LV） peak systolic strain rate and left ventricuiar ejection fraction（LVEF） in essential hypertension patients with different left ventricular patterns. Methods： The left ventricular mass index（LVMI） and relative wall thickness （RWT） were evaluated by echocardiography in 55 cases with essential hypertension and 30 normal control subjects. According to level of LVMI and RWT, patients with hypertension were divided into patterns of normal geometric LV （LVN, n=22） and remodeling LV（LVR）, which including concentric remodeling（n=13）, concentric hypertrophy（n=7） and eccentric hypertrophy（n=10）. The apical views were used to determine the SSR. Strain rate imaging was applied for obtaining peak systolic strain rate（SSR） of the LV basal and middle segments. The left ventricular systolic function was evaluated by means of SSR in all sites. LVEF was determined by Simpson＇s rule in all patients and control subjects. Results： In all groups, mean SSR by SRI of LV wall correlated negatively and closely with the LVEF （r1=-0.82, r2=-0.84 and r3=-0.94, P〈0.001）. Mean SSR was significantly descending in the control groups, LVN group and LVR group（P〈0.05）. Although LVEF were significantly lower in LVR group than in LVN group（P〈0.05）, there had no significant difference between control group and LVN group（P〉 0.05）. Conclusion： SRI provides a sensitive, simple and trustful tool to assess globie LV function in patients with essential hypertension.