摘要
目的采用实时三维超声(RT-3DE)及二维斑点追踪成像(2D-STI)评估原发性高血压患者左心房形态和功能。方法收集70例原发性高血压患者,根据左心房内径指数将其分为左心房无扩大(NLAE)组(n=35)和左心房扩大(LAE)组(n=35),并收集35名健康志愿者为对照组。应用RT-3DE检测最大、最小和收缩前左心房容积(LAVmax、LAVmin、LAVpre),计算左心房每搏输出量(LASV)、总射血分数(LAEF)、主动射血分数(LAaEF)和被动排空分数(LApEF)。采用2D-STI计算左心房壁的收缩期、舒张早期和晚期平均峰值应变率(mSRs、mSRe、mSRa)。比较3组间上述参数的差异,分析2D-STI与RT-3DE测量参数的相关性。结果与对照组比较,NLAE组LAaEF、mSRa增高,LApEF、mSRs、mSRe降低(P均<0.05);与NLAE组比较,LAE组LAVmax、LAVpre、LAVmin、LASV、LAaEF、mSRa增高,LAEF、LApEF、mSRs、mSRe降低(P均<0.05)。NLAE组和LAE组中,mSRs与LAEF(r=0.70、0.77)、mSRe与LApEF(r=0.80、0.82)、mSRa与LAaEF(r=0.87、0.89)呈明显正相关(P均<0.01)。结论原发性高血压患者左心房在重构前即已发生功能改变;RT-3DE和2D-STI技术可用于评价原发性高血压患者左心房结构和功能。
Objective To evaluate the structure and function of left atrium(LA) in patients with essential hypertension by real-time three-dimensional echocardiography(RT-3 DE) and two-dimensional speckle tracking imaging(2 D-STI). Methods Totally 70 essential hypertension patients and 35 healthy volunteers(control group) were enrolled. The patients were divided into no left atrial enlargement(NLAE) group and left atrial enlargement(LAE) group(each n=35) according to left atrial index. Using RT-3 DE, the maximal, minimal and pre-systolic LA volume(LAVmax, LAVmin and LAVpre) were measured, the stroke volume, total ejection fraction, active ejection fraction and passive ejection fraction of LA(LASV, LAEF, LAaEF, LApEF) were calculated. Using 2 D-STI, the mean peak strain rates in systolic, early-diastolic, end-diastolic phase(mSRs, mSRe, mSRa) of LA were calculated. The parameters among the 3 groups were compared, the correlation between 2 D-STI and RT-3 DE measurement parameters were analyzed. Results Compared with control group, LAaEF and mSRa increased, while LApEF, mSRs and mSRe decreased in NLAE group(all P<0.05). Compared with NLAE group, LAVmax, LAVpre, LAVmin, LASV, LAaEF and mSRa increased, while LAEF, LApEF, mSRs and mSRe decreased in LAE group(all P<0.05). Significant positive correlations were found between mSRs and LAEF(r=0.70, 0.77), mSRe and LApEF(r=0.80, 0.82) as well as mSRa and LAaEF(r=0.87, 0.89) in NLAE and LAE group(all P<0.01). Conclusion LA function has changed before LA geometry changes in essential hypertension patients. RT-3 DE and 2 D-STI play important role in assessing LA function of essential hypertension patients.
作者
陈晓沛
姜志荣
王小凡
吕启凤
宋晓霞
田雨
CHEN Xiaopei;JIANG Zhirong;WANG Xiaofan;LYU Qifeng;SONG Xiaoxia;TIAN Yu(Department of Medical Imaging, Medical College of Qingdao University,Qingdao 266000, China;Department of Cardiac Ultrasound, Affiliated Hospital of Qingdao University, Qingdao 266000, China)
出处
《中国医学影像技术》
CSCD
北大核心
2019年第6期843-847,共5页
Chinese Journal of Medical Imaging Technology
关键词
高血压
心房功能
左
斑点追踪
超声检查
hypertension
atrial function,left
speckle tracking
ultrasonography