超声斑点追踪成像评价不同构型高血压患者左室心肌应变

Left ventricular myocardial strain in hypertension patient with different geometric patterns using speckle tracking imaging

目的采用二维超声斑点追踪成像(STI)技术探讨原发性高血压患者左心室心肌纵向、径向、周向应变特点,评价不同构型的原发性高血压患者左室收缩功能。方法原发性高血压患者63例,根据左室心肌质量指数(LVMI)将其分为左室非肥厚组33例(A组)与左室肥厚组30例(B组),选取健康者49例(对照组),获取左室长轴及短轴各切面的收缩期纵向、径向、圆周峰值应变。结果 B组各心肌节段及整体纵向收缩期峰值应变(LS)均显著低于正常组及A组,(P<0.01);左心室短轴切面A组3个短轴水平径向收缩峰值应变(RS)高于正常组(P<0.01);B组3个短轴水平RS明显低于正常组及A组(P<0.01);B组圆周收缩峰值应变(CS)均明显低于正常组及A组(P<0.05)。结论 STI能准确评价高血压患者左心室心肌整体及局部收缩功能的异常,对高血压患者早期左心室收缩功能异常诊断有着重要的临床意义。

Objective To assess left ventricular systolic function with the peak systolic strain of longitudinal ,radial and circumferential in patients with essential hypertension by using speckle tracking imaging. Methods Sixty-three cases of patients with essential hypertension （EH） were enrolled, who were classified into the left ventricular hyper trophy group （ n = 30） and the non left ventricular hypertrophy group （ n = 33 ）, according to the left ventricle mass index （LVMI）. The peak systolic longitudinal strain （LS） ,the peak systolic radial strain（RS） and circumferential strain （CS） were measurened in left ventricular long-axis and short-axis views by STI software. Results The peak systolis longitudinal strain of segments and global of left ventricular of group B decreased compared with the control group and group A（ P 〈0. 01 ） ; the peak systolic radial strain of three segments of hytension group A increased sig nificantly composed with control group（ P 〈 0. 01 ）, but RS of group B slightly decreased compared with the control group and group A （P 〈0. 01 ） ; the peak systolic circumferential strain of three segments of group B were slight lower than the control group and group A （P 〈 0. 05 ） ; Conclusions Speckle tracking imaging can assess left ventricular systolic function in gloal or local regiong of essential hypertention, which have important clical significance to evaluate early the left ventricular systolic function with essential hypertention.