RT-3DE联合血BNP对HFNEF的临床诊断价值

Correlation study of clinical diagnosis of HFNEF by RT-3DE combined with blood BNP

目的:对于实时三维超声心动图(实时三维超声心动图,RT-3DE)探讨临床心脏衰竭射血分数正常和血清脑利钠肽分级的左室舒张功能的诊断价值。方法:选取具有心衰症状及体征且LVEF≥50%的实验组48例,健康体检36例为对照组。运用实时三维超声心动图按照《2016 ASE/EACVI指南与标准》对左室舒张功能进行分级。测量实验组和对照组BNP浓度水平。分析左室舒张功能Ⅰ、Ⅱ、Ⅲ级参数间的关系,分析左室舒张功能分级与BNP之间的关联。结果:①应用实时三维超声心动图所测量的LAVI值、E/e'比值、E/A比值和TR值实验组和对照组间有显著差异(P<0.05);②左室舒张功能分级与BNP浓度水平具有相关性(rs=0.890,P<0.05);③左房容积指数随着BNP浓度的变化呈正相关变化(r=0.790,P<0.05);E/e'比值与BNP呈示正相关性(r=0.837,P<0.05)。结论:运用实时三维超声心动图测得E/A比值,TR值、LAVI值,E/e'比值评估左室舒张功能,结合血清脑钠肽对临床诊断左室射血分数正常心力衰竭具有重要诊断价值。

Objective:To investigate the clinical value of three-dimensional echocardiography(RT-3DE)combined with serum brain natriuretic peptide(BNP)in the diagnosis of heart failure(HFNEF)patients with normal ejection fraction.Methods:Forty-eight patients with heart failure with signs and symptoms of heart failure but left ventricular ejection fraction(LVEF)≥50%were selected as the experimental group,and 36 patients with healthy physical examination during the same period were selected as the control group.According to 2016 ASE/EACVI guidelines and standards,real-time three-dimensional echocardiography was used to grade the left ventricular diastolic function of the experimental group.Serum BNP levels in the experimental and control groups were measured.Analysis of left ventricular diastolic functionⅠ,Ⅱ,Ⅲlevel parameters,the relationship between the analysis of left ventricular diastolic function classification and the correlation between the BNP concentration.Results:Left atrial volume index(LAVI),E/E',E/A and TR values were measured by real-time three-dimensional echocardiography in the two groups,and the differences between the two groups were statistically significant(P<0.05).Left ventricular diastolic function grade was correlated with serum BNP concentration(r=0.890,P<0.05).LAVI value,E/E'ratio and serum BNP concentration were positively correlated(r=0.790,r=0.837,P<0.05).Conclusion:RT-3DE combined with serum BNP has important value in the clinical diagnosis of HFNEF,and can improve the diagnostic accuracy by studying the correlation between LAVI,E/E',E/A and TR of RT-3DE and serum BNP.