应变率成像对肺动脉高压患者左心室舒张功能的评价

The evaluation on systolic function by strain rate imaging in patients with pulmonary hypertension

目的应用应变率成像(SR I)评价肺动脉高压右心室负荷过重状态下的左心室舒张功能的变化。方法用应变率成像及定量组织速度成像等方法,分析左心室各壁的应变率曲线及二尖瓣环组织运动曲线,测定28例肺动脉高压患者和25例正常健康体检者的左心室各壁的收缩期应变率(SRs),舒张早、晚期应变率(SRe、SRa),计算平均舒张早、晚期应变率(mSRe、mSRa)及其比值(mSRe/mSRa);二尖瓣环各壁的舒张早、晚期运动速度(Ve、Va),计算平均舒张早、晚期运动速度及其比值(Ve/Va)。结果肺动脉高压组的舒张早期应变率、平均舒张早期应变率及平均舒张早/晚应变率比值低于对照组(P<0.01);肺动脉高压组与正常对照组收缩期应变率与舒张晚期应变率比较差异无统计学意义;二尖瓣环的平均舒张早期运动速度及平均舒张早/晚期运动速度之比低于正常对照组(P<0.01)。结论应变率成像可以准确评价肺动脉高压患者的左心室舒张功能,为临床选择最佳治疗方案提供客观依据。

Objective To assess the left ventricular diastolic function in the patients with pulmonary hypertension by strain rate imaging （SRI）. Methods tissure velocity imagine （QTVI） were performed on The Doppler echocardiography, SRI and quantitative patients with pulmonary hypertension （n = 28 ） and healthy subjects （ n = 25 ）. The strain rate of curve in mid-segments of left ventricular was respectively acquired in four chamber view, three chamber view, two chamber view; systolic strain rate （SRs）, early di- astolic strain rate （SRe）, later diastolic strain rate （SRa） were measured at middle ventricle. The mean early diastolic strain rate （mSRe）, mean later diastolic strain rate （mSRa） and mSRe/mSRa ratio were cal- culated. The peak velocity during early diastole （Ve） and later diastole （Va） were measured on myocardial movement curve of every segments. The mean early diastole, mean later diastole velocity and Ve/Va also were calculated. Results The parameters of SRe, mSRe, mSRe/mSRa ratio, early diastolic velocity of the mitral annulus in pulmonary hypertension group were significantly lower than those in healthy subjects; Com- pared with healthy subjects, SRs and SRa were not different in patients. Conclusions The study showed that SRI could evaluate the left ventricular global diastolic function in patients with pulmonary hypertension, which could provide useful information for therapeutic strategies.