实时三平面组织同步成像技术评价高血压病患者左心室心肌收缩同步性

Evaluation of left ventricular systolic synchronicity in patients with essential hypertension by real-time tri-plan tissue synchronization imaging

目的应用实时三平面组织同步成像(TSI)技术评价原发性高血压病患者左心室心肌收缩的同步性,探讨其临床意义。方法原发性高血压病左室心肌肥厚(LVH)患者44例,原发性高血压病无左室心肌肥厚(NLVH)患者52例,健康者32例为对照组,应用实时三平面TSI技术测量左心室前壁、侧壁、后壁、下壁和室间隔的基底段和中间段等12个心肌节段的收缩达峰时间(Tp),计算Tp平均值(Tp-mean)和标准差(Tp-sd)。结果与对照组比较,高血压病组Tp-mean延长(P<0.001)、Tp-sd增大(P<0.01),且LVH组Tp-mean和Tp-sd较NLVH组延长、增大(P<0.001)。左心室心肌质量指数(LVMI)与Tp-mean呈正相关(r=0.53,P<0.01)。结论高血压病患者左心室心肌收缩存在不同步性,且在心肌肥厚状态下心肌收缩不同步性增大。TSI技术对高血压病患者左心室局部心肌功能的全面评价具有重要价值。

Objective To assess the clinical value of left ventricular systolic synchronicity in patients with essential hypertension （ EH ） by real - time tri - plan tissue synchronization imaging （ TSI ）. Methods Forty - four left ventricular hypertrophy patients with EH, 52 non - left ventrieular hypertrophy patients with EH and 32 normal subjects were enrolled in this study. The time to peak systolic velocity （Tp） of basal and middle segments of anterior , lateral , posterior, inferior , and septal walls in total 12 segments were measured by real - time tri - plan TSI. Stand deviation of Tp （ Tp - sd ） and mean value of Tp （Tp- mean） were calculated. Results In patients with EH, Tp -mean was longer（ P 〈 0. 001 ）and Tp -sd was increased （P 〈 0. 01 ）, compared with normal subjects. While in left ventricular hypertrophy patients with EH, Tp -mean and Tp -sd were significantly longer and increased compared with non - left ventricular hypertrophy patients with EH（ P 〈 0. 001 ）. Tp - mean was positively correlated with LVMI （ r = 0. 53, P 〈 0.01 ）. Conclusion Left ventricular systolic dyssynchronicity is exist in patients with EH, and the left ventricular systolic dyssynchronicity is increased in the condition of left ventricular hypertrophy. TSI has important value in evaluating left ventricular systolic synchronicity in patients with EH.