超声二维应变评价慢性心力衰竭患者右室心肌纵向收缩功能

Ultrasound two-dimensional strain evaluates right ventricular longitudinal systolic function in patients with chronic heart failure

目的:应用二维应变技术研究慢性心力衰竭(CHF)患者右室心肌的应变能力。方法:对31例CHF患者及31例正常人进行超声心动图检查,经胸采集并存储3个心动周期的标准心尖四腔二维图形。运用EchoPAC超声工作站进行脱机分析,在二维应变模式下测量右室游离壁及室间隔右室面基底段、中间段及心尖段的纵向收缩期峰值应变和右室整体收缩期峰值应变。比较各收缩期峰值应变在两组间的差异。同时测量并分析右室面积变化率和右室射血分数与右室整体收缩峰值应变的相关性。结果:CHF组右室游离壁及室间隔基底段、中间段、心尖段及右室整体收缩期峰值应变均较正常对照组显著减低,差异具有统计学意义(P<0.01)。右室整体收缩期峰值应变与右室面积变化率及右室射血分数均呈正相关(r=0.567,P<0.01;r=0.546,P<0.01)。结论:CHF患者的右室心肌纵向收缩功能减低。

Objective ： To evaluate right ventricular longitudinal systolic function in patients with chronic heart failure （CHF） using ultrasound two-dimensional strain. Method： Thirty-one patients with CHF and 31 healthy controls were included in this study. Two-dimensional images were obtained at the apical four-chamber views and then were analyzed offline by using automated sofeware （EchoPAC, GE Medical）. The myocardial longitudinal peak systolic strain was determined at the basal, mid, and apical segment of the right ventricular free wall and ventricular septum by two-dimensional strain. Right ventricular global longitudinal peak systolic strain was also obtained by two-dimensional strain. The data were compared during the chronic heart failure group and healthy group. Right ventricular fractional area change and right ventricular ejection fractions were measured, and correla- tion of these parameters with right ventricular global longitudinal peak systolic strain Was analyzed. Result：Com- pared with the controls, the longitudinal peak systolic strain of right ventricular global and free wall for all seg- ments in patients with CHF were obviously lower （P^0.01） . Right ventricular fractional area change and right ventricular ejection fractions were correlated with the right ventricular global longitudinal peak systolic strain in patients with chronic heart failure （ r = 0.567, P 〈 0.01 ; r = 0. 546, P 〈 0.01 ）. Conclusion： The right ventricular longitudinal systolic function in patients with CHF were impaired.