继发性肺高压患者的右心室应变分析

Effect of pulmonary hypertension on right ventricular regional strain

目的了解继发性肺高压(pulmonary hypertension,PH)对右心室整体及局部应变(strain,S)的影响。方法选取20名健康成年人作为正常组,在我院心外科拟行手术治疗的19例继发性PH患者作为PH组,采用Philipie33超声诊断仪,在心尖四腔心切面采集右心室的组织多普勒成像图像,将右心室侧壁及室间隔分为右心室基底段、右心室心尖段、室间隔心尖段和室间隔基底段共4个节段,分别测量右心室各节段的S值及右心室平均S值。结果两组间各节段S值及S值达峰时间的差异均有统计学意义(P值均<0．01)。正常组中, 70％以右心室基底段S值最高;PH组中,68％以右心室心尖段S值最高;且PH组的右心室心尖段S值仍低于正常组的右心室基底段(P<0．05)。PH组的肺动脉收缩压与右心室基底段S值及右心室平均S值均无相关性(P值均>0．05)。PH组的心率为(87．9±12．3)次／min,明显高于正常组的(68．8±1．7)次／min(P<0．01),校正心率(测值／R-R间期的平方根)后,两组间各节段S值及右心室平均S值达峰时间的差异亦无统计学意义(P值均>0．05)。结论PH时,右心室平均S值减低,主要是由右心室侧壁基底段S值减低所致;而右心室应变的同步性不受影响。

Objective To evaluate the changes of regional right ventricular （RV） strain （S） in secondary pulmonary hypertension （PH） patients. Methods Nineteen patients with PH [PH group, mean age （40. 1 ±17.3） years] and twenty normal subjects [normal group, mean age （46. 2 ± 13. 3） years] underwent tissue Doppler imaging （TDI） evaluation of RV regional and mean contractility. Results There was no statistical significance among the RV regional time to peak S values in each group. After the heart rate correction, TDI showed no statistical difference in the time to peak S values between the two groups. Conclusions RV mean S decreases in PH patients mainly caused by the changes of RV lateral basal S. The synchronization of RV strain remains in the patients withPH.