应变-应变率对不同构型高血压左室收缩功能的评价

Strain and strain rate evaluation of systolic function of left ventricular for patients with different patterns of hypertension

目的通过应变-应变率探讨不同左心室构型原发性高血压患者左心室长轴方向应变-应变率在收缩期的变化及其与左室射血分数(EF)、左室短轴缩短率(FS)的关系。方法采用M型、二维超声测量不同构型高血压患者左心室室壁厚度、左室舒张末期内径、EF、FS,并计算左心室质量指数(LVMI)、相对室壁厚度(RWT),根据LVMI和RWT将高血压分为正常左室构型(B)、向心性重构(C)、向心性肥厚(D)和离心性肥厚(E)4组,每组均取20例,正常对照组20例(A),测量应变ε及应变率S。结果①收缩期应变,应变率在5组间差异均有显著性(P<0.05);②EF、FS在离心性肥厚与其余各组间比较,差异有显著性(P<0.05),其余各组内EF、FS差异无显著性(P>0.05)。结论应变-应变率成像为临床提供了一个敏感、简便、可靠的评价原发性高血压患者左室收缩功能的指标。

【Objectives】To evaluate the systolic function of left ventricular （LV） for patients with different patterns of hypertension with strain and strain rate, and its relation with ejection fraction （EF） and shortening fraction （FS）. 【Methods】M-mode, 2-D and doppler ultrasonic and strain/strain rate were used to test the thickness of LV wall, inner diameter of LV, EF, FS, and calculate LV weight index （LVWI）, relative wall thichness （RWT）, and all patients were divided into 4 groups according to LVMI and RWT： normal geometric （B）, concentric reconstruction （C）, concentric hypertrophy （D） and eccentric hypertrophy （E）, 20 cases in each group, other 20 normal people were taken as control （A）. LV systolic strain （ε） and strain rate （S） were tested.【Results】Systolic strain rate S and ε had significantly difference in all groups： decreased gradually from group A to group E. EF and FS in eccentric hypertrophy were clearly lower than control, other 3 groups of hypertension had no difference from control.【Conclusion】 Strain and strain rate image provide to clinic a sensitive, simple and reliable method to evaluate LV function for patients with primary hypertension.