纵向分层应变评价早期系统性红斑狼疮左心室收缩功能及同步性改变

Longitudinal layer-specific strain imaging in evaluation of early changes of left ventricular systolic function and synchrony in patients with systemic lupus erythematosus

目的应用纵向分层应变成像技术评价亚临床系统性红斑狼疮(SLE)左心室收缩功能及同步性早期改变。方法收集42例SLE患者(SLE组)及30名健康体检者(对照组),储存左心室心尖3个长轴切面的二维灰阶动态图像,离线分析获得左心室心肌分层纵向应变(LS)参数及各节段LS达峰时间的标准差(PSD),比较组间各参数差异。根据SLEDAI-2000评分标准将SLE组分为非活动期(SLE-)及活动期(SLE+)2个亚组,分析相关参数差异。结果相比对照组,除心尖段各层心肌外,SLE组整体、基底段及中间段3层心肌LS均减低(P均<0.05);其中SLE+亚组整体、基底段及中间段3层心肌LS均减低(P均<0.05),SLE-亚组左心室整体、基底段心内膜下心肌均减低(P均<0.05)。SLE组总体及2亚组PSD均高于对照组(P均<0.05),2亚组间左心室3层心肌LS及PSD差异无统计学意义(P均>0.05)。结论纵向分层应变技术能较敏感地评估亚临床SLE患者左心室心肌改变。

Objective To explore the early changes of left ventricular systolic function and synchrony in systemic lupus erythematosus(SLE)patients with longitudinal layer-specific strain imaging.Methods Forty-two SLE patients(SLE group)and 30 healthy subjects(control group)were collected.Two-dimensional gray-scale moving images of three long axial sections of the left ventricular apex were stored,and the parameters of the longitudinal strain(LS)and peak strain dispersion(PSD)were obtained.The differences of these parameters were compared between groups.According to SLEDAI-2000 scoring system,the patients were divided into inactive phase(SLE-)subgroup and active phase(SLE+)subgroup,and the differences of related parameters were further analyzed.Results Compared with control group,except apical segment,the LS of global and segmental three-layer myocardium decreased in SLE group(all P<0.05).Among SLE group,LS of global and segmental three-layer myocardium decreased in SLE+subgroup(all P<0.05),while only the endocardial LS of the global,basal of left ventricle were found lower in SLE-subgroup than in control group(both P<0.05).PSD were higher in SLE group and both 2 subgroups of SLE than in control group(all P<0.05).There was no significant difference of LS of left ventricular myocardium nor PSD between 2 subgroups of SLE(all P>0.05).Conclusion Longitudinal layer-specific strain imaging can be used to sensitively evaluate the subclinical left ventricular myocardial changes in SLE patients.