三维斑点追踪成像技术评价高血压患者左心室收缩功能

Assessment of left ventricular systolic function by three-dimensional speckle tracking imaging in patients with essential hypertension

目的探讨三维斑点追踪成像(3D-STI)技术评价早期高血压患者左心室收缩功能的价值。方法获取无左心室肥厚的原发性高血压患者(高血压组,30例)和正常人(对照组,25例)左心室全容积图像并存储,应用3D-STI技术分析获取左心室射血分数(LVEF)、左室质量指数(LVMI)、纵向总应变(GLS)、圆周总应变(GCS)、面积总应变(GAS)、径向总应变(GRS)及相应的各节段峰值应变。结果高血压组GLS低于对照组[(18.20±2.25)%vs.(22.33±3.08)%](P<0.05),高血压组GAS低于对照组[(33.30±2.67)%vs.(37.42±4.36)%](P<0.05)。高血压组后间隔基底段及中段、前间隔基底段及中段、前壁基底段、侧壁基底段及中段的纵向应变低于对照组(P<0.05)。高血压组后间隔基底段、前间隔基底段及中段、侧壁基底段的面积应变低于对照组(P<0.05)。结论高血压患者在早期LVEF正常时即可出现整体及部分节段纵向应变及面积应变减低。3D-STI技术可以更全面的定量评估高血压患者左心室整体及节段收缩功能。

Objective To investigate the value of three-dimensional speckle tracking imaging （3D-STI） in assessing left ventricular systolic function in patients with essential hypertension（EH）. Methods A full-volume scan of left ventricle was acquired from the apical view for 3D-STI analysis in 30 EH patients without left ventricular hypertrophy（group EH） and 25 healthy volunteers（group C）. Global longitudinal strain（GLS）, global circumferential strain（GCS）, global area strain（GAS）, global radial strain（GRS） and corresponding segmental peak systolic strains, left ventricular ejection fraction （LVEF） and left ventricular mass index（LVMI） were obtained for statistical analysis. Results GLS and GAS were significantly lower in group EH than those in group C[（18. 20±2. 25）% vs. （22.33±3.08）% and （33.30±2.67）% vs. （37.42±4. 36）%]（P〈0. 05）. So did the longitudinal strains of basal and middle septum, basal and middle anteroseptum, basal anterior wall, basal and middle lateral wall as well as the area strains of basal septum, basal and middle anteroseptum, basal lateral wall （P〈0. 05）. Conclusions EH patients with normal LVEF may have a reduction of longitudinal and area strains. 3D-STI can be used to evaluate quantitatively and comprehensively the global and segmental systolic functions in EH patients.