左室整体心肌及心内膜下心肌短轴应变在糖尿病早期心功能诊断中的价值

Early detection of left ventricular whole and subendocardial myocardium function in patients with diabetes mellitus by speckle tracking imaging

目的应用斑点追踪成像技术评价糖尿病患者及糖尿病合并高血压患者左室短轴心内膜下心肌早期的收缩功能。方法 3组检测对象分别为单纯糖尿病组、糖尿病合并高血压组及对照组各30例。应用超声心动图测量常规参数及应用超声斑点追踪成像技术测量左室短轴整体及心内膜下心肌不同水平各节段二维应变值,比较3组间的差异。结果 3组间的常规参数比较,糖尿病组E/A比值的变化差异有统计学意义(P<0.01)。3组间的不同水平节段二维应变值比较,糖尿病组及糖尿病合并高血压组左室短轴整体心肌部分节段二维应变有所减低(P<0.01);糖尿病组及糖尿病合并高血压组左室短轴心内膜下心肌大部分节段二维应变均减低(P<0.01),其中糖尿病合并高血压组心内膜下心肌部分节段比单纯糖尿病组更低(P<0.01)。结论斑点追踪成像技术能早期发现局部心肌功能的改变,可以作为监测糖尿病心肌损伤的一个重要参考指标。

Objective To analyze early systolic function of subendocardial myocardium of the left ventricular short-axis view in patients with diabetes mellitus（DM）and DM associated hypertension by speckle tracking imaging（STI）.Methods All subjects included 30 patients with diabetes mellitus（DM group）,30 patients with DM associated hypertension（DH group）and30healthy volunteers（control group）.The common parameters of echocardiogram were measured and the peak systolic strain of whole and subendocardial myocardium were analyzed from the short-axis view at the levels of mitral annulus,papillary muscle and apex by STI.All the above parameters were compared among the three groups.Results The ratio of E/A was significantly lower in the two patient groups than those of control group（P〈0.01）.The peak systolic radial strain and circumferential strain of a few segments were significantly lower in the two patient groups than those of control group（P〈0.01）.The peak systolic radial strain and circumferential strain of the subendocardial myocardium of bulk segments in the two patient groups differently decreased compared with the control group（P〈0.01）.The peak systolic radial strain and circumferential strain of the subendocardial myocardium of the DH group except some segments decreased compared with the DM group（P〈0.01）.Conclusion Speckle tracking imaging can be early used to identify the left ventricular systolic function and monitor myocardial damage in patients with diabetes mellitus.