超声心动图评价肺动脉高压患者的左心功能

Evaluation on left ventricular function in patients with pulmonary hypertension with echocardiography

目的应用超声心动图评价肺动脉高压(PH)患者的左心功能。方法对39例PH患者(PH组)和27名健康志愿者(对照组)行全面超声心动图检查,测量右心功能、左心收缩及舒张功能。留取胸骨旁左心室短轴切面(乳头肌水平)和心尖四腔心切面动态图像,采用斑点追踪分析软件测量左心室心肌整体收缩期环形应变(GCSS)、径向应变(GRSS)及纵向应变(GLSS)。对两组测量结果进行对比分析。结果 PH患者右心功能减低,左心室舒张功能减低,左心室射血分数(LVEF)无明显变化(66.48%±6.38%vs 65.26%±4.01%,P>0.05)。左心室心肌GCSS(-15.66%±3.67%vs-18.56%±2.16%,P<0.01),GRSS(15.54%±5.35%vs 30.03%±9.64%,P<0.01)和GLSS(-16.18%±4.35%vs-20.91%±2.96%,P<0.01)绝对值均较对照组明显减低。结论中重度PH患者左心室舒张功能明显减低;尽管LVEF无明显变化,其左心室心肌收缩功能存在不同程度减低。

Objective To evaluate the left ventricular function in patients with pulmonary hypertension（PH） with echocardiography.Methods Thirty-nine patients with PH（PH group） and 27 healthy volunteers（control group） underwent detailed echocardiography examination.Right ventricular function,left ventricular diastolic function and left ventricular systolic function were evaluated.Parasternal mid short axis view and apical four-chamber view were obtained.Global circumferential systolic strain（GCSS）,global radial systolic strain（GRSS）,global longitudinal systolic strain（GLSS） were calculated with software of speckle tracking imaging（STI）.The results of the two groups were compared.Results Right ventricular dysfunction and left ventricular diastolic dysfunction happened in patients with PH.There was no significant difference in left ventricular ejection fraction（LVEF） between control group and PH group（66.48%±6.38% vs 65.26%±4.01%,P0.05）.However,the absolute value of GCSS（-15.66%±3.67% vs-18.56%±2.16%,P0.01）,GRSS（15.54%±5.35% vs 30.03%±9.64%,P0.01） and GLSS（-16.18%±4.35% vs-20.91%±2.96%,P0.01） of PH group were lower than control group.Conclusion Left ventricular diastolic dysfunction happens in patients with moderate-sever PH.Although LVEF is normal,LV myocardial dysfunction has happened.