应变率成像与定量组织速度成像技术评价高血压病左室舒张功能

Assessment of left ventricular diastolic function in patients with essential hypertension using strain rate imaging and quantitative tissue velocity imaging

目的探讨应变率成像与定量组织速度成像技术评价高血压病左室舒张功能的临床价值。方法采用脉冲多普勒、应变率成像与定量组织速度成像技术检测了30例高血压病患者和30例正常人的二尖瓣口舒张期血流频谱、左室基底部和中部(左室前壁、下壁、前间隔、后壁、后间隔和侧壁)心内膜下心肌层的应变率曲线以及二尖瓣环间隔、侧壁、前壁、下壁四个位置的舒张早期运动峰值速度Ea波与舒张晚期运动峰值速度Aa波。结果高血压病组的E/A与正常对照组比较降低(P<0.05),而左室舒张早期与舒张晚期峰值应变率比值(SRe/SRa)及Ea/Aa与正常对照组比较显著降低(P<0.01)。两组的Ea/Aa与E/A呈显著正相关(高血压病组:r=0.712,P<0.01;正常对照组:r=0.748,P<0.01);两组的SRe/SRa与E/A也呈显著正相关(高血压病组:r=0.805,P<0.01;正常对照组:r=0.769,P<0.01)。结论Ea/Aa、SRe/SRa比E/A能更敏感反映高血压病患者的左室舒张功能状况。

Objective To explore the value of strain rate imaging and quantitative tissue velocity imaging which evaluating left ventricular diastolic function in patients with essential hypertension. Methods Thirty patients with essential hypertension and thirty healthy subjects were measured by three methods：the frequency spectrum of mitral valve blood flow in diastolic phase, the tissue velocity of mitral annulus and the average myocardial strain rate of left ventricle. The parameters of pulse Doppler, strain rate imaging and quantitative tissue velocity imaging were measured. These data were analyzed and compared. Results Compared with the healthy subjects, the parameters of E/A was reduced （ P 〈 0.05） while the parameters of SIRe/SRa and Ea/Aa were significantly reduced（ P 〈 0.01 ）. Ea/Aa had a positive correlation with E/A（hypertension group： r = 0. 712, P 〈 0.01 ; normal control group： r = 0. 748, P 〈 0.01 ） ; SRe/ SRa also had a positive correlation with E/A（hypertension group： r = 0. 805, P 〈 0.01 ; normal control group： r = 0. 769, P 〈 0.01 ）. Conclusion The ratios of Ea/Aa and SRe/SRa are more sensitive targets of left ventricular diastolic function than E/A in essential hypertenslon.