应变率成像评价不同左心室构型原发性高血压患者右心室局部功能

Evaluation of regional right ventricular function in essencial hypertension patients with different modes of left ventricle by strain rate imaging

目的探讨应变率成像技术检测不同左室构型原发性高血压（HBP）患者右室收缩、舒张功能的应用价值。方法HBP患者38例，根据左室质量指数（LVMI）和相对室壁厚度（RWT）值分为左室正常构型（LVN）组和左室重构（LVR）组，对照组23例。获取各受试者心尖四腔观清晰组织速度成像（TVI）图存盘供脱机分析。测量三尖瓣环处心肌收缩期峰值运动速度（Vs）、舒张早期峰值运动速度（Ve）、舒张晚期峰值运动速度（Va），计算Ve／Va；右室游离壁中部心内膜下心肌收缩期峰值应变（Ss）、收缩期峰值应变率（SRs）、舒张早期峰值应变率（SRe）、舒张晚期峰值应变率（SRa），计算SRe／SRa。结果与对照组比较，高血压LVN组患者三尖瓣环Vs和Ve差异无统计学意义，Ve／Va减低；与对照组及高血压LVN组比较，高血压LVR组患者Vs差异无统计学意义，Ve、Ve／Va均显著减低；与对照组比较，高血压LVN组、LVR组患者右室游离壁中部心内膜下心肌SRs差异无统计学意义，Ss、SRe、SRe／SRa均显著减低；与高血压LVN组比较，高血压LVR组患者SRs差异无统计学意义，Ss、sRe、SRe／SRa均显著减低。结论HBP患者无论左室构型有无变化，其右室局部收缩、舒张功能已受损，应变率成像技术能准确评价其右室局部功能。

Objective To evaluate the value of strain rate imaging（SRI） in quantitatively detecting regional right ventricular function in hypertension（HBP） patients with different mode of left ventricle. Methods Thirty eight patients with HBP were divided into left ventricular nermal （LVN） and left ventricular remodeling（LVR） groups according to left ventricular mass index（LVMI） and relative wall thiekness（RWT）. Twenty-three controls were performed echocradiography examination. Tissue velocity imagings of all the patients and controls were accepted in apical four chamber views. The indies included： peak systolic velocity（Vs）, peak early diastolic velocity（Ve）, peak late diastolic velocity（Va） and Ve/Va of triscular annulus, peak systolic strain rate （ SRs）, peak early diastolic strain rate （ SRe）, peak late diastolic strain rate（SRa） and SRe/SRa of right ventricular free wall. Results Compared with controls, Ve/Va of LVN group decreased significantly,but there were no difference in Vs and Ve. Compared with LVN group and controls, Ve and Ve/Va of LVR group decreased significantly, but there were no significarrtly difference in Vs. Compared with controls, Ss, SRe and SRe/SRa of LVN and LVR group decreased significantly, but there was no significantly difference in SRs; compared with LVN group, Ss, SRe and SRe/SRa of I.VR group decreased significantly, but there was no significantly difference in SRs. Conclusions The systolic and diastolic function of RV in patients with HBP damaged with or without left ventricular remodeling;SRI can evaluated regional right ventrieular funciton in these patients accurately.