组织多普勒成像评测左心房组织速度、应力与三维超声心动图评测左心房容积的相关性分析

Correlationship of Left Atrial Tissue Velocity,Strains Evaluated by Tissue Doppler Imaging and Left Atrial Volume Evaluated by Three-Dimensional Echocardiography

目的分析组织多普勒成像(TDI)测得的健康心、左房室瓣狭窄(MS)或左房室瓣反流(MR)患者的左心房局部组织速度、应力与三维超声心动图测定的左心房容积变化的相关性。方法健康心、中重度MS患者、中重度MR患者各22例,应用TDI和三维超声心动图分别评估左心房局部组织速度、应力和左房时间-容积曲线,并进行相关性分析。结果健康心组最大左房容积与后壁长轴收缩应力呈负相关(r=-0.49,P<0.05);时间-最大左房容积与时间-后壁长轴峰应力(r=0.60,P<0.05)和时间-环状峰应力均呈正相关(r=0.64,P<0.05)。MS患者和MR患者的最大左房容积与节段应力和应力率均无显著相关(P>0.05)。MS患者的最大左房容积与径向收缩期组织峰速度(r=-0.61,P<0.05)和后壁长轴舒张晚期组织峰速度均呈负相关(r=-0.76,P<0.05);时间-最大左房容积与时间-前壁(r=0.65,P<0.05)、后壁(r=0.57,P<0.05)长轴峰应力均呈正相关。MR患者时间-最大左房容积与时间-后壁长轴峰应力(r=0.63,P<0.05)和侧壁长轴峰应力(r=0.57,P<0.05)、时间-环状峰应力(r=0.55,P<0.05)均呈正相关。结论与径向应力相比,左房长轴和环状应力在评估左房容积和功能中作用更显著;TDI和超声评测MS患者较MR患者的左心房病理特征更为显著。

Objective To analyze the correlation of left atrial （LA） regional tissue velocities and strains in healthy heart,mitral stenosis （MS） or mitral regurgitation （MR） evaluated by Tissue Doppler imaging （TDI） and LA volume change evaluated by three-dimensional echocardiography （TDE）.Methods Twenty-two persons with healthy heart,22 patients with moderate-to-severe MS,and 22 patients with moderate-to-severe MR were enrolled.their tissue velocities,strains,and time-volume curves of the LA were examined by using TDI and TDE.The results were analyzed for correlation.Results In healthy heart persons,the maximal LA volume was negatively correlated with the posterior wall longitudinal systolic strain （r=-0.49,P〈0.05）.The time-to-maximal LA volume was positively correlated with the time-to-posterior wall longitudinal peak strain （r=0.60,P〈0.05） and the time-to-circumferential peak strain（r=0.64,P〈0.05）.The maximal LA volume was not significantly correlated with the segmental late diastolic tissue strain and strain rate in both MS and MR patients （P〈0.05）.In patients with MS,the maximal LA volume was negatively correlated with the posterior wall radial peak systolic velocity （r=-0.61,P〈0.05） and the longitudinal late diastolic velocity （r=-0.76,P〈0.05）.The time-to-maximal LA volume were positively correlated with the time-to-anterior and time-to-posterior wall longitudinal peak strains （r=0.65 and r=0.57,P〈0.05,respectively）.In patients with MR,the time-to-maximal LA volume was positively correlated with the time-to-posterior and lateral wall longitudinal peak strains （r=0.63 and r=0.57,P〈0.05,respectively）,and with the time-to-circumferential peak strain （r=0.55,P〈0.05）.Conclusion Compared with radial deformations,the LA longitudinal and circumferential deformations are of more value to evaluate LA volume and function.And the LA of patients with MS shows more significant a pathologic feature than that of patients with MR under TDI and TDE.