评价慢性主动脉瓣反流患者左心室心肌应变的研究进展

Progress of assessment of left ventricular myocardial strain in patients with chronic aortic regurgitation

主动脉瓣反流（AR）是常见的瓣膜疾病,是由于主动脉瓣叶或主动脉根部疾病造成舒张期主动脉瓣对合不良导致血流由主动脉根部逆流回左心室.由于心脏的代偿机制,患者早期可无明显症状,左心室射血分数正常.部分患者尽管左心室射血分数正常,但已发生不可逆的心肌功能障碍.现总结组织多普勒成像（TDI）、斑点追踪技术（STE）、速度向量成像（VVI）以及心脏磁共振成像（CMR）等多种技术评价慢性主动脉瓣反流患者左心室心肌应变的最新进展,以期更早期地发现亚临床的左心室功能障碍,为临床诊断和治疗提供参考信息.

Aortic regurgitation（AR）is a common valvular disease.AR results from diastolic valve malcoaptation caused by disease of either the aortic leaflets and/or the aortic root, leading to the retrograde flow from the aortic root into the left ventricle. Due to the compensatory mechanism of the heart, patients with chronic AR remain asymptomatic, with preserved left ventricular ejection fraction （LVEF） in early period. However, irreversible myocardial dysfunction may occur despite normal LVEF. Now this review summarizes the new progress of assessment of left ventricular myocardial strain in patients with chronic AR by tissue Doppler imaging （TDI）, speckle tracking echocardiography （STE）, velocity vector imaging （VVI） and cardiac magnetic resonance imaging （CMR）, hoping to help detect subclinical left ventricular dysfunction and provide reference information for clinical diagnosis and treatment.