二维斑点追踪超声心动图在评价老年心力衰竭患者心功能和二维整体应变中的作用

Study on the role of 2D speckle tracking echocardiography in evaluation of cardiac function and two-dimensional integral strain in elderly patients with heart failure

目的探讨二维斑点追踪超声心动图在评价老年心力衰竭患者心功能和二维整体应变中的作用。方法选择心力衰竭患者共58例,分为轻度心力衰竭组22例,中度心力衰竭组20例,重度心力衰竭组16例,另外选择健康对照组30例,比较各组左心房前后径(LA)、左心室舒张末径(LVEDD)、左心室收缩末容积(LVESV)与左室射血分数(LVEF)以及整体径向应变(GRS)、整体圆周应变(GCS)、整体纵向应变(GLS)。结果重度心力衰竭组患者LA、LVEDV、LVESV和LVEF与轻度心力衰竭组、中度心力衰竭组和对照组存在显著统计学差异(P<0.05)。GLS、GCS、GRS在三组间有统计学差异,其中重度心力衰竭组GLS显著低于轻度心力衰竭组和中度心力衰竭组以及对照组(P<0.05),但GCS在轻度心力衰竭组和中度心力衰竭组中无统计学差异(P>0.05)。三组心力衰竭的患者GRS均显著低于对照组(P<0.05),但三组之间的GRS比较无统计学差异(P>0.05)。结论二维整体应变指标GLS、GCS、GRS可反映不同程度老年心力衰竭患者心肌不同收缩功能的损伤,其中纵向应变在评价心肌收缩功能中有较高的临床应用价值。

Objective To explore the role of 2D speckle tracking echocardiography in evaluation of cardiac function and two - dimensional integral strain in elderly patients with heart failure. Methods A total of 58 cases of heart failure were divided into mild heart failure group （22 cases）,moderate heart failure group （20 patients） and severe heart failure group （16 cases）. In addition, 30 healthy persons were selected as control group. The diameter of left atrium （ LA） , left ventricular end diastolic diameter （ LVEDD） , left ventricular end - systolic volume （ LVESV）, left ventricular ejection fraction （ LVEF） and global radial strain （ GRS） , global circumferential strain （ GCS） and global longitudinal strain （GLS） were compared among these groups. Results The diffemce in LA, LVEDV , LVESV and LVEF among severe heart failure group, moderate heart failure group, mild heart failure group and control group was statistically significant. Among these three groups, the difference in GLS, GCS and GRS was significant, and they were significantly lower in severe heart failure group than those of mild heart failure, moderate heart failure and control groups. In patients of severe heart failure group, GCS was lower than that of mild and moderate heart failure groups, but the difference was not significant. GRS in patients of these three groups was significantly lower than that of control group. Conclusion The two - dimensional strain indices as GLS, GCS and GRS may differently respond to different degrees of impairment in myocardial contractile function in elderly patients with heart failure, while the longitudinal strain has higher clinical significance in evaluation of myocardial contractile function.