血流向量成像及二维组织追踪技术对2型糖尿病患者左心房功能及左心房-左心室耦联关系的评估

Left atrial function and left atrial-left ventricular coupling assessed by vector flow mapping and two- dimensional tissue tracking echocardiography in patients with type 2 diabetes mellitus

目的通过血流向量成像（VFM）及二维组织追踪（2DTT）技术评估糖尿病患者左房功能及左房一左室耦联关系。方法本研究共纳入51例2型糖尿病患者（糖尿病组）及38例健康志愿者（对照组）。采用2DTT技术分析左房及左室机械力学参数；通过VFM分析左房及左室收缩期能量损失（LVELs）、舒张早期能量损失（LVELed）及心房收缩期能量损失（LVELac）。结果糖尿病组左室能量损失明显高于对照组（P〈0．05）。对照组收缩期左房能量损失（LAELs）及舒张早期左房能量损失（LAELed）均高于糖尿病组，但心房收缩期左房能量损失（LAELac）则明显减低（均P〈0．05）。多重线性回归分析显示E、LVELed是LAELed的独立预测因素；峰值扭转速度、收缩期左房应变及LVELac是LAELac的独立预测因素。结论糖尿病患者左房储备、通道功能减低，而泵功能代偿性增加，左房一左室耦联关系也出现异常。

Objective To detect left atrial （LA） function and left ventricular （LV）-LA coupling using vector flow mapping （VFM） and two-dimensional tissue tracking （2DTT） echocardiography in patients with diabetes. Methods A total of 51 patients with type 2 diabetes （DM group） and 38 healthy volunteers （control group） were studied. LA and LV strain were assessed by 2DTT. The energy loss （EL） of LA and LV during ventricular systole （ELs）, early diastole （ELed）, and atrial contraction （ELac） were measured by VFM. Results LVEL in DM group was significantly increased compared to that in control group （ P 〈 0.05）. LAELs and LAELed in control group were higher than those in DM group （ P〈 0.05） ;while LAELae decreased in control group （ P 〈0.05）. Multivariate regression analysis identified E and LVELed as independent predictors of LAELed ; Peak torsion, LA peak systolic strain and LVELae were independent predictors of LAELae. Conclusions The reservoir and conduit function of LA are impaired in patients with DM, while the pump function increases as a compensation. Abnormal LA-LV coupling also appears in patients with DM.