二维超声斑点追踪显像技术评价高血压患者左心室旋转和扭转运动的临床应用

Evaluation of Left Ventricular Rotation and Torsion in Patients with Primary Hypertension by Two-Dimensional Speckle Tracking Imaging

目的:采用二维超声斑点追踪成像技术测定高血压患者左心室旋转和扭转运动,评价其临床应用价值。方法:20例正常人和44例原发性高血压患者[包括左心室构型正常组(LVN组)21例和左心室重构组(LVR组)23例]获得心尖水平和基底水平左室短轴清晰二维图像存盘,运用QLAB超声工作站进行脱机分析,得到内膜旋转峰值、外膜旋转峰值、平面旋转峰值及平面扭转峰值,计算左心室整体的扭转峰值。结果:①基底水平:与正常组比较,LVN组内膜旋转峰值、跨壁扭转峰值显著增高(P<0.05);LVR组内膜旋转峰值、平面旋转峰值、跨壁扭转峰值显著增高(P<0.05)。与LVN组比较,LVR组内膜旋转峰值、外膜旋转峰值、平面旋转峰值和跨壁扭转峰值均显著增高(P<0.05)。②心尖水平:与正常组比较,LVR组内膜旋转峰值、平面旋转峰值和跨壁扭转峰值显著增高(P<0.05)。与LVN组比较,LVR组内膜旋转峰值、外膜旋转峰值、平面扭转峰值显著增高(P<0.05)。③左心室整体扭转:与正常组比较和与LVN组比较,LVR组扭转峰值均显著增高(P<0.05)。结论:超声二维斑点追踪显像技术可以准确评价高血压患者左心室旋转和扭转运动,高血压患者旋转与扭转运动力学参数较正常人整体上有明显增高。

Objective： To assess the value of left ventricular （LV） rotation and torsion in patients with hypertension by 2-dimensional ultrasound speckle tracking imaging （STI）. Methods： Two-dimen- sional images of LV at basal and apical short axis view were acquired in 44 patients with hypertension, which included normal geometric LV group （LVN group, n= 21） and remodeling LV group （LVR group,n=23）, and in 20 healthy subjects to evaluate LV rotation and torsion. Peak endomembranal rotation, peak membranal rotation, peak bulk rotation, and peak mural torsion were measured separately. Results： （1）At basal LV level, when compared to the control group, peak endomembranal rotation and peak mural torsion significantly increased in LVN group respectively （both P〈0.05）. Peak endomembranal rotation, peak bulk rotation, and peak mural torsion significantly increased in LVR group （all P〈0.05）. Compared with those in the LVNgroup, peak endomembranal rotation, peak membranal rotation, peak bulk rotation and peak mural torsion significantly increased in LVR group （all P〈0.05）. （2）At apical LV level, when compared to the control group, peak endomembranal rotation, peak bulk rotation and peak mural tor sion significantly increased in LVR group （all P 〈0. 05）. Compared with those in the LVN group, peak membranal rotation, peak membranal rotation, and peak bulk rotation significantly increased in LVR group （all P〈0.05）. （3）LV torsion of LVR group significantly higher than that of control and LVN groups respectively （both P〈0.05）. Conclusion： STI can exactly evaluate the characteristics of LV rotation and torsion in patients with hypertension.