斑点追踪成像以R波及P波顶点为起始评价正常人左心房功能的差异

Differentiation of left atrial strain using P-wave and R-wave trigger of speckle tracking imaging in healthy subjects

目的探讨超声二维斑点追踪成像(STI)以R波及P波为起始测量评价正常人左心房功能的差异。方法对85名健康志愿者进行超声检查,采用二维超声心动图测量左心房被动射血分数(LAPEF)、左心房主动射血分数(LAAEF)、左心房射血分数(LATEF)、左心房扩张指数(LAEI)。分别采用STI以R波及P波为起始测量左心房收缩期应变(Rres、Pres)、舒张早期应变(Rcon、Pcon)、舒张晚期应变(Rpump、Ppump)。结果 Pres、Pcon、Ppump均小于Rres、Rcon、Rpump(P均<0.05)。传统超声心动图指标与Pres、Pcon、Ppump的相关性好于与Rres、Rcon、Rpump的相关性。结论测量左心房功能时以P波为起始更准确,STI可准确评价左心房功能,为临床提供了一种新方法。

Objective To explore the left atrial （LA） strain differentiation by using R-wave and P-wave as starting point in speckle tracking echocardiography （STE）. Methods Totally 85 healthy subjects were enrolled. The LA passive ejection fraction （LAPEF）, LA active ejection fraction （LAAEF）, LA total ejection fraction （LATEF） and LA expansive index （LAEI） were measured with two-dimensional echocardiography. Two-dimensional strain was performed in all patients, and set the starting point of strain analysis as R-wave peak or P-wave peak. The starting points of R-wave peak （Rres, Rcon, Rpump） and P-wave （Pres, Pcon, Ppump） onset were separately used to calculate the LA stain during the reservoir, con- duit, and booster pump phase from the LA strain curve respectively. Results Compared with Rres, Rcon, Rpump, the Pres, Pcon, Ppump were greater （all P^0.05）. The correlation between conventional echocardiography and P-wave trig- ger parameters were better than correlation between R-wave trigger parameters. Conclusion LA strain analysis should use P-wave onset as the starting point. STI provides an accurate method to evaluate the LA function.