超声血流向量成像技术评价原发性高血压患者左心房早期功能不全

Ultrasonic vector flow mapping in evaluation of early left atrial dysfunction in patients with primary hypertension

目的探讨超声血流向量成像(VFM)技术评价原发性高血压患者早期左心房功能不全的价值。方法收集左心房未增大的高血压患者56例(高血压组)及同期健康成年人32名(对照组),采用VFM技术测量左心房心腔内能量损耗(EL),包括快速射血期EL(EL-S)、舒张早期EL(EL-ED)和心房收缩期EL(EL-AC);采用二维超声组织追踪成像(2DTT)技术,测量收缩期左心房峰值应变(SLAs)、舒张早期左心房峰值应变(SLAed)、心房收缩期左心房峰值应变(SLAac)、收缩期左心房应变率(SRLAs)、舒张早期左心房应变率(SRLAed)和心房收缩期左心房应变率(SRLAac);比较2组间差异,并分析左心房EL的独立影响因素。结果高血压组EL-S、EL-AC高于对照组(P均<0.01),2组间EL-ED差异无统计学意义(P=0.469)。SLAed[标准化系数(β)=-0.434,P<0.001]是EL-S、SLAs(β=0.396,P<0.001)是EL-ED、SLAac(β=-0.474,P<0.01)是EL-AC的独立影响因素。结论 VFM技术可评价高血压患者左心房血液流场能量损耗状态,可作为高血压早期左心房功能受损的评价指标。

Objective To explore the value of vector flow mapping（VFM）in evaluation on early left atrial dysfunction in patients with primary hypertension.Methods Totally 56 patients with hypertension without enlargement of left atrial（hypertension group）and 32 healthy adults（control group）were enrolled.The energy loss（EL）of left atrium,including rapid ejection period energy lose（EL-S）,early diastolic energy loss（EL-ED）and atrial systolic energy loss（EL-AC）were obtained with VFM techniques.Also,the left atrial systolic peak strain（SLAs）,left atrial early diastolic peak strain（SLAed）,left atrial late diastolic peak strain（SLAac）,left atrial systolic strain rate（SRLAs）,left atrial early diastolic strain rate（SRLAed）and left atrial strain rate during left artial contraction（SRLAac）were measured with twodimensional ultrasound tissue tracking imaging（2 DTT）.Then the differences of each parameter were compared between the two groups,and the independent predictors of EL were analyzed.Results EL-S and EL-AC in hypertension group were higher than those in control group（both P〈0.01）,while there was no statistical difference of EL-ED between the two groups（P=0.469）.SLAed（standardization coefficient[β]=-0.434,P〈0.001）,SLAs（β=0.396,P〈0.001）and SLAac（β=-0.474,P〈0.01）was the independent predictor of EL-S,EL-ED and EL-AC,respectively.Conclusion VFM can be used to evaluate EL of left atrial blood flow field in hypertensive patients,also as an indicator of left atrial dysfunction in patient with early hypertension.