实时三维超声心动图斑点追踪技术测量高血压心肌肥厚患者收缩期左室心肌应变

Evaluation of left ventricular strain by real-time three-dimensional speckle tracking echocardiography in patients with hypertension and myocardial hypertrophy

目的采用实时三维超声心动图斑点追踪技术研究原发性高血压心肌肥厚患者的收缩期左室心肌应变特点。方法采用三维超声心动图斑点追踪技术对37例原发性高血压心肌肥厚患者及27例健康志愿者进行了室壁运动分析，测量左室纵向、圆周向、径向、面积应变，比较两组间各应变参数的差异，并分析各项整体应变参数与左室射血分数（LVEF）的相关性。结果高血压心肌肥厚患者的左室整体纵向、径向和面积应变较正常对照组明显减低，左室整体圆周向应变与对照组间无明显差异。纵向、径向、圆周向应变在左室基底段、中段明显减低，圆周向应变减低仅见于基底段。左室整体纵向、圆周向、径向、面积应变与LVEF具有相关性。结论实时三维超声心动图斑点追踪技术可检测到高血压心肌肥厚患者左室局部心肌收缩功能的减低。

Objective To investigate left ventricular （LV） strain in patients with hypertension （HT） and myocardial hypertrophy using three-dimensional speckle tracking echocardiography. Methods Myocardial movement was analyzed in 37 primary HT patients with myocardial hypertrophy and 27 healthy volunteers. LV longitudinal,circumferential, radial and area strains were measured. The correlation between each global strain parameter and LV ejection fraction （LVEF） was analyzed. Results LV global longitudinal strain（GSL）, global radial strain（GSR） and global area strain （GSA） of HT patients with myocardial hypertrophy were significantly lower than the contrast group, whereas global circumferential strain（GSC） showed no significant difference between the two groups. Longitudinal,radial and area strains were decreased in LV basal and middle levels, while decreased circumferential strain was detected only in basal level. There were significant correlations between LVEF and GSL, GSC, GSR, GSA. Conclusions Impairment of LV regional myocardial contractility can be detected by three-dimensional speckle tracking echocardiography.