二维斑点追踪成像技术评价原发性高血压患者左心室心内膜下心肌收缩功能

Assessment of left ventricular inner-half layer myocardium function in primary hypertension patients using two-dimensional speckle tracking imaging

目的 :应用二维斑点追踪成像技术监测原发性高血压患者左心室心内膜下心肌应变,探讨其变化规律及临床意义。方法:选择原发性高血压患者73例,依据左心室心肌质量指数,将其分为无左心室肥厚组(NH)33例和左心室向心性肥厚组(CH)40例,并与正常对照组40例进行比较。应用二维斑点追踪成像技术分别测量左心室整体收缩期纵向峰值应变(GLPSSa)、心内膜下心肌的收缩期纵向峰值应变(GLPSSi)、左心室整体收缩期径向峰值应变(GRPSSa)、心内膜下心肌的收缩期径向峰值应变(GRPSSi)。结果:与正常对照组比较,NH组和CH组的GLPSSa、GLPSSi均降低(均P<0.05)。NH组的GRPSSa与正常对照组比较,差异无统计学意义(P>0.05);GRPSSi也升高且差异显著(P<0.01),CH组的GRPSSa、GRPSSi均降低且差异显著(P<0.01)。结论:二维斑点追踪成像技术能够准确、客观地评价不同程度高血压患者左心室心内膜下心肌应变的变化;原发性高血压患者心内膜下心肌收缩功能改变早于心肌全层。

Objective：To assess the change of left ventricular inner-half layer myocardium strain in primary hypertension pa-tients using two-dimensional speckle tracking imaging,to investigate its change regulation and clinical significance. Methods：We chose 73 patients with primary hypertension,then divided them into two groups due to the left ventricular mass index （LVMI）, one group was 33 cases without left ventricular hypertrophy （NH）,the other group was 40 cases with left ventricular concentric hypertrophy （CH）. And then chose 40 volunteers as control group. Use two-dimensional speckle tracking imaging to record the global peak systolic longitudinal strain of the whole layer myocardium （GLPSSa） and the inner-half layer myocadium （GLPSSi）,the global peak systolic radial strain of the whole layer myocardium （GRPSSa） and the inner-half layer myocadium （GRPSSi）. Results：Compared with the control group,the GLPSSa、GLPSSi of NH and CH group decreased and had statistical significance （P〈0.05）. Compared with the control group,the GRPSSa of NH group increased but had no statistical significance （P〉0.05）,but the GRPSSi of NH group significantly increased and had statistical significance （P〈0.01）. The GRPSSa and GRPSSi of CH group were both significantly decreased and had statistical significance （P〈0.01）. Conclusion：Two-dimensional speckle tracking imaging can assess the change of left ventricular inner-half layer myocardial strain in different degrees of pri-mary hypertension patients accurately and objectively .The systolic function of left ventricular inner-half layer myocardial changes earlier than the whole layer myocardium.