正常构型高血压患者左室应变的三维斑点追踪技术分析

Left ventricular strain analyzed by 3-dimensional speckle tracking technology in patients with hypertension of normal geometric patterns

目的采用三维斑点追踪技术,分析正常构型的高血压患者左室的三维应变,为早期发现高血压心脏功能改变提供依据。方法选择左室构型正常的高血压患者(高血压组)50名和年龄匹配的健康体检者(对照组)50名,采用心脏超声测定常规心脏参数,并采用三维斑点追踪技术测定受检者的总体纵向(LS)、圆周(CS)、面积(AS)、径向应变(RS)峰值及球形指数(SPI),并在两组之间进行对比分析。结果左室内径、左室后壁、室间隔、相对室壁厚度(RWT)、左室质量指数(LVMI)、左室射血分数(EF)、球形指数及圆周应变在两组间差异无统计学意义(P>0.05);LS、AS及RS在正常构型的高血压组显著低于对照组(P<0.05)。结论三维斑点追踪显示正常构型的高血压患者左室收缩功能已经开始下降,其敏感性优于EF,是检测心室收缩功能早期改变很好的方法。

Objective To adopt the three-dimensional speckle tracking technology to analyze the left ventricular three-dimensional strain in .patients with hypertension of normal geometric patterns to provide a basis for early finding the hypertensive cardiac function change. Methods Fifty patients with hypertension of normal geometric patterns and age-matched individuals undergoing physical examination were selected. The routine cardiac parameters were measured with cardiac echocardiography,furthermore the three-dimensional speckle tracking technology was adopted to detect the global longitudinal strain（GLS）, global circumferential strain（GCS）, global area strain（GAS）, global peak radial strain（GRS） and spherical index（SPI）. All parameters were compared between the two groups. Results The left ventricular internal diameter, posterior wall of left ventricle,interventricular septum, relative wall thickness（RWT）, left ventricular mass index（LVMl）, left ventricular ejection fraetion（EF）, SPI and GCS had no statistical differences between the two groups（P〉0.05） ; GLS, GAS and GRS in the hypertension with normal geometric patterns group were significantly lower than those in the control group（P〈0.05）. Conclusion Three-dimensional speckle tracking technology displays the decrease of left ventricular systolic function in the patients with hypertension of normal geometric patterns,its sensitivity is superior to EF, which is a good method to detect early changes of left ventricular systolic function in hypertension.