2D-STI技术评价原发性高血压患者早期左心房功能的临床研究

Clinical Study of 2D-STI Technique in Evaluating Early Left Atrial Function in Patients with Essential Hypertension

目的应用二维斑点追踪成像(2D-STI)技术探讨原发性高血压患者早期左房功能的变化。方法 2017年1月—2018年1月对该院门诊初诊原发性高血压病患者50例,正常对照组50例,行超声心动图检查并存储图像。采用2D-STI技术测量左房节段的左心室收缩期,舒张早期和舒张晚期纵向峰值应变(SLAs,SLAe,SLAa)及应变率(SRs,SRe和SRa)计算其平均应变值(mSLAs,mSLAe,mSLAa)及平均应变率值(mSRs,mSRe和mSRa)。结果原发性高血压组与健康对照组心室结构各项指标和左心房容积参数比较差异无统计学意义(P<0.05)。与对照组相比原发性高血压组收缩期平均峰值应变(SLAs)[(25.65±4.60)%vs (21.05±5.80)%]及应变率(mSRs)[(1.72±0.56)/s vs(1.42±0.47)/s]减低(t=4.394, P=0.000; t=2.404, P=0.016),舒张早期平均峰值应变(SLAe)[(-15.45±3.97)%vs (-11.21±4.8)%]及应变率(m SRe)[(-1.68±0.57)/s vs(-1.37±0.65)/s]减低(t=4.813, P=0.000; t=2.536, P=0.013)。舒张晚期平均峰值应变(SLAa)[(-7.69±2.54)%vs (-8.38±3.56)%]及应变率(mSRa)[(-1.58±0.50)/s) vs (-1.66±0.59)/s]两组间比较,略有增加,差异无统计学意义(t=-1.116, P=0.298; t=-0.731, P=0.423)。结论高血压早期心室收缩期及舒张早期左心房整体应变及应变率的减低,舒张晚期整体应变及应变率总体维持。二维斑点追踪成像技术可用于早期左房功能异常的评价。

Objective To investigate the changes of early left atrial function in patients with essential hypertension by two-dimensional speckle tracking imaging(2 D-STI). Methods From January 2017 to January 2018, 50 patients with primary hypertension were enrolled in the outpatient department of our hospital, and 50 patients in the normal control group. Echocardiography was performed and images were stored. The left ventricular systolic phase of the left atrial segment was measured by 2 D-STI technique, and the mean strain values(mSLAs, mSLAe, mSLAa) were calculated by the longitudinal peak strain(SLAs, SLAe, SLAa) and strain rate(SRs, SRe and SRa) in the early and late diastolic phases, and average strain rate values(mSRs, mSRe and mSRa). Results There were no significant differences in ventricular structure parameters and left atrial volume parameters between the primary hypertension group and the healthy control group(P<0.05). Systolic mean peak strain(SLAs) in the essential hypertension group compared with the control group [(25.65±4.60%% vs(21.05±5.80)%] and strain rate(mSRs)[(1.72±0.56)/s vs(1.42±0.47)/s] decreased(t=4.394,P=0.000;t=2.404, P=0.016), early peak diastolic strain(SLAe)[(-15.45±3.97)% vs(-11.21±4.8)%) and strain rate(mSRe)[(-1.68±0.57)/s vs(-1.37±0.65)/s] decreased(t=4.813, P=0.000;t=2.536, P=0.013). Late diastolic mean peak strain(SLAa)[(-7.69±2.54)% vs(-8.38±3.56)%] and strain rate(mSRa)[(-1.58±0.50)/s) vs(-1.66±0.59)/s] There was a slight increase in the comparison between the two groups, and the difference was not statistically significant(t=-1.116,P=0.298;t=-0.731, P=0.423). Conclusion In the early stage of systolic and early diastolic hypertension, the overall left atrial strain and strain rate are reduced, and the overall strain and strain rate in the late diastolic phase are maintained.Two-dimensional speckle tracking imaging technology can be used to evaluate early left ventricular dysfunction.