超声血流向量显像技术在原发性高血压左心室肥厚诊断中的应用

Application of ultrasound vector flow mapping in the diagnosis of essential hypertensive left ventricular hypertrophy

目的:探讨超声血流向量显像(VFM)技术在原发性高血压左心室肥厚(LVH)诊断中的应用价值。方法:收取42例左室肥厚原发性高血压患者为LVH组,36例左室不肥厚原发性高血压患者为心室正常组,30例健康体检者为对照组。所有受试者均接受常规心动图、VFM检查及双频脉冲多普勒检查,记录常规超声数据、等容收缩期能量耗损(IVC-EL)、等容舒张期能量耗损(IVR-EL)、射血期能量损耗(EP-EL)以及充盈期能量耗损(FP-EL),利用工作特征曲线(ROC)评估VFM技术诊断高血压LVH的价值。结果:LVH组患者的BMI、SBP、DBP、常规心脏超声指标LVMI、左房前后径(LAD)、室间隔厚度(IVSd)、左心室后壁厚度(LVPW)均明显高于对照组(P<0.01)。LVH组不同心动周期EL的EP-EL、IVC-EL均高于心室正常组和对照组(P<0.001),但FP-EL低于心室正常组和对照组(P<0.05)。ROC结果显示:EP-EL、IVC-EL和FP-EL诊断LVH高血压的AUC分别为0.757、0.732和0.737,95%CI分别为0.652~0.862、0.623~0.842和0.629~0.846。结论:VFM技术的EL参数(包括EP-EL、IVC-EL和FP-EL)有望成为诊断原发性高血压LVH的指标之一。

Objective:To explore the application value of ultrasound vector flow mapping(VFM)in the diagnosis of hypertensive left ventricular hypertrophy(LVH).Methods:42 patients with left ventricular hypertrophy and essential hypertension were enrolled as LVH group,36 patients with essential hypertension without left ventricular hypertrophy were selected as normal ventricular group,30 healthy persons were selected as control group.All underwent routine cardiogram,VFM and dual-frequency pulse Doppler examination.The routine ultrasound data,energy loss of isovolumic contraction(IVC-EL),energy loss of sisovolumic relaxation(IVR-EL),energy loss of ejection phase(EP-EL)and energy loss of filling phase(FP-EL)were recorded.The diagnostic value of VFM in hypertensive LVH was evaluated by receiver operating characteristic(ROC)curves.Results:The BMI,SBP,DBP,conventional echocardiographic indicators LVMI,left atrium anterior and left atrial diameter(LAD),interventricular septal thickness(IVSd)and left ventricular posterior wall thickness(LVPW)of the patients in LVH group were significantly higher than those of the control(P<0.01).The EP-EL and IVC-EL of EL in different cardiac cycles of the LVH group were higher than those of the normal ventricular group and the control group(P<0.001),while the FP-EL was lower than that of the normal ventricular group and the control group(P<0.05).Additionally,the ROC results showed that AUC values and 95%CI of EP-EL,IVC-EL and FP-EL for diagnosis of hypertensive LVH were(0.757,0.732,0.737)and(0.652-0.862,0.623-0.842,0.629-0.846),respectively.Conclusion:The EL of VFM parameters including EP-EL,IVC-EL and FP-EL are expected to be one of the indicators for diagnosing hypertension and LVH.