二维应变超声心动图定量评价糖尿病患者左室纵向局部心肌功能

Quantitative assessment of two dimensional strain echocardiography in long-axis regional systolic function of left ventricle in patients with diabetes mellitus

目的:应用二维应变超声心动图(2D-SE)研究左室射血分数正常的2型糖尿病患者左室纵向局部心肌功能改变,探讨2D-SE的临床应用价值。方法:应用GEVivid7-Dimension超声心动图仪分别采集30例糖尿病患者与30例正常对照者心尖左室长轴、心尖四腔和心尖左室二腔观的二维灰阶动态图像。应用自动功能成像软件(AFI)自动测量长轴方向左室18节段收缩峰值应变。结果:糖尿病组和对照组左室舒张末容积(LVEDV)、左室收缩末容积(LVESV)、每搏输出量(SV)及左室射血分数均在正常范围,两组比较差异无显著性(P>0.05)。与对照组比较,糖尿病组左室18节段收缩期纵向峰值应变显著降低,各个节段组间比较差异有显著性(均P<0.01)。结论:糖尿病患者左室纵向局部心肌收缩功能受损常早于整体收缩功能出现障碍。2D-SE可以用来定量评价左室射血分数正常的糖尿病患者左室局部心肌功能改变。

Objective To assess the long-axis regional systolic function of the left ventricle （LV） in patients with type 2 diabetes mellitus （ T2DM） using two-dimensional strain echocardiography（2D-SE）and explore clinical application value of 2D-SE.Methods 30 T2DM patients with normal LV ejection fraction （LVEF≥55%）,30 normal controls were selected.The peak strain of segments in apical long-axis,four-chamber,and two-chamber views were evaluated,and average peak strain in the long axis at basal,middle and apical levels were assessed by automated functional imaging（AFI）.Results LVEDV,LVESV,SV and LVEF in T2DM patients and normal controls were all within normal limits.Furthermore,there was no significant difference between the two groups （P0.05）.Compared with normal controls,the peak strain at each plane in T2DM patients was significantly reduced （P0.01）.Conclusion The long-axis regional systolic function of LV in the patients with T2DM is impaired ahead of global systolic function disturbance. 2D-SE may be used to identify early abnormalities of systolic function in T2DM patients with normal LVEF.