二维应变超声心动图评价高血压病人左心室长轴收缩功能

INVESTIGATION OF LEFT VENTRICULAR LONG-AXIS SYSTOLIC FUNCTION IN HYPERTENSION PATIENTS BY TWO-DIMENSIONAL STRAIN ECHOCARDIOGRAPHY

目的 应用二维应变超声心动图评价左心室射血分数正常的原发性高血压病人左心室长轴收缩功能的变化。方法 选取左心室射血分数正常的原发性高血压病人132例，分为正常构型组（NG组）、向心性重构组（CR组）、向心性肥厚组（CH组）、离心性肥厚组（EH组），并以34例健康志愿者作为对照组（NC组）。应用二维应变超声心动图测量左心室各节段收缩期纵向峰值应变，计算各组受检者整体纵向峰值应变。结果 NC、NG、CR、CH组整体纵向峰值应变呈明显的递减趋势（F=6.54，q=2.23～4.36，P〈0.05）；EH组整体纵向峰值应变与NG、CR、CH组比较显著减低（q=3.89～4.36，P〈0.01），与CH组比较差异无显著性（P〉0.05）。结论 随着心肌重塑的进展，左心室长轴收缩功能损害逐渐加重。

Objective To investigate the left ventricular long-axis systolic function （LVLASF） in essential hypertension （EH） patients with normal left ventricular ejection fraction （LVEF） using two-dimensional strain echocardiography （2DSE）. Methods One hundred and thirty-two EH patients with normal LVEF were enrolled in this study, who were divided to normal configuration （NC） group,concentric remodeling （CR） group,concentric hypertrophy （CH） group and eccentric hypertrophy （EH） group, and 34 healthy volunteers served as normal controls （NC）. Using 2DSE to measure and calculate systolic longitudinal strain of each segment and the global longitudinal strains of the subjects in each group. Results The global longitudinal strains of left ventricle tended to decrease progressively in order of groups NC, NG, CR, and CH （F=6.54,q=2.23-4.36,P〈0.05）. The glo-bal longitudinal strains of left ventricle in EH group were more significantly decreased than that in NG, CR, and CH groups （q=3.89-4.36,P〈0.01）, and no significant difference was noted between groups CH and EH （P〉0.05）. Conclusion With the progression of myocardial remolding, the long-axis systolic dysfunction of the left ventricular aggravates.