心肌应变分析技术评价肺动脉高压患者右室功能

Assessment of right ventricular function in patients with pulmonary arterial hypertension by myocardial strain analysis

目的应用心肌应变分析技术评价肺动脉高压患者右室功能,探讨其临床应用价值。方法选取肺动脉高压患者68例(肺动脉高压组)和正常对照组68例,于右室前游离壁-后间隔切面、中游离壁-中间隔切面及后游离壁-前间隔切面应用心肌应变分析技术测量纵向收缩峰值应变,获得右室整体纵向收缩峰值应变(GS)及17节段应变,并对两组进行比较;分析右室GS与肺动脉收缩压的相关性。结果肺动脉高压组患者右室GS、前游离壁基底段应变、中游离壁基底段应变、后游离壁基底段应变、前游离壁中段应变、中游离壁中段应变、中间隔基底段应变、前间隔基底段应变、中间隔中段应变及前间隔中段应变均较正常对照组减低(均P<0.05)。右室GS与肺动脉收缩压呈负相关(r=-0.784,P<0.01)。结论心肌应变分析技术评价肺动脉高压患者右室功能具有可行性,为临床评估右室整体及局部收缩功能提供了新的方法。

Objective To evaluate the right ventricular function in patients with pulmonary hypertension(PH) by myocardial strain analysis,and to explore its clinical application value.Methods Sixty-eight PH patients(PH group) and 68 healthy controls(control group) were enrolled.Myocardial strain analysis technique was applied to measure the right ventricular longitudinal peak systolic strain of three sections:anterior free wall-posterior ventricular septum,middle free wall-middle ventricular septum,posterior free wall-anterior ventricular septum.The global strain(GS) and 17-segment strain values were obtained and then compared between groups.The correlation between the GS of right ventricular and the pulmonary arterial systolic pressure(PASP) was analyzed.Results There were significant differences of GS of right ventricle,basal segment strain of anterior free wall,basal segment strain of free wall,basal segment strain of posterior free wall,middle segment strain of anterior free wall,middle segment strain of free wall,basal segment strain of ventricular septum,basal segment strain of anterior ventricular septum,middle segment strain of ventricular septum,and middle segment strain of anterior ventricular septum between the two groups(all P<0.05).Therefore,it was considered that the right ventricular GS and the above-mentioned segment strains in PH group were reduced from those in control group.The GS of right ventricle presented correlation with PASP(r=-0.784,P<0.01).Conclusion It is feasible to perform multi-angular analysis on the right cardiac functions of PH by myocardial strain analysis technique.This technology is also an innovative approach of evaluating the overall and regional systolic functions of right ventricle.