应变率成像评价高血压合并阵发性心房颤动患者左心房心肌功能

Evaluation of left atrial myocardial function in hypertensive patients with paroxysmal atrial fibrillation using strain rate imaging

目的:应用实时三平面应变率成像检测高血压合并阵发性心房颤动患者左心房心肌功能的变化,探讨其临床意义。方法:选取单纯高血压患者35例、高血压合并阵发性心房颤动患者32例、正常人33例,应用实时三平面应变率成像检测左心房心肌收缩期平均峰值应变率(MSRs)、舒张早期平均峰值应变率(MSRe)和心房收缩期平均峰值应变率(MSRa)。结果:MSRs在正常人、单纯高血压患者和高血压合并阵发性心房颤动患者中呈逐渐减低的变化(P<0.0001);MSRe在单纯高血压患者中显著减低(P<0.01),在高血压合并阵发性心房颤动患者中无显著性变化(P>0.05);MSRa在单纯高血压患者中显著增高(P<0.01),在高血压合并阵发性心房颤动患者中显著减低(P<0.05)。结论:高血压患者左心房心肌功能受损,合并阵发性心房颤动时受损程度加重,实时三平面应变率成像对高血压患者左心房心肌功能的全面评估具有重要应用价值。

To evaluate the alteration of left atrial myocardial function in hypertensive patients with paroxysmal atrial fibrillation using real time triplane strain rate imaging and to investigate its clinical significance. Methods： Thirty five solitary hypertensive patients, 32 hypertensive patients with paroxysmal atrial fibrillation and 33 healthy subjects were enrolled. Mean systolic peak strain rate, mean early diastolic peak strain rate and mean late diastolic peak strain rate（MSRs, MSRe and MSRa） were measured using real time triplane strain rate imaging. Results： There was a significantly step down change among control group, hypertensive group and hypertensive with paroxysmal atrial fibrillation group in MSRs（P〈0.0001）, MSRe was sig- nificantly decreased in hypertensive group （P〈0.01）, MSRe had no significant difference in hypertension with paroxysmal atrial fibrillation group （P〉0.05）, MSRa was significantly increased in hypertensive group （P〈0.01）, while MSRa was decreased in hy pertension with paroxysmal atrial fibrillation group（P〈0.05）. Conclusions： The left atrial myocardial function in hypertensive pa tients is significantly impaired, which is worsen in hypertensive patients with paroxysmal atrial fibrillation, real time triplane strain rate imaging provides important applicable significance in the comprehensive evaluation of left atrial myocardial function in hypertensive patients.