二维斑点追踪技术评价单纯超重和肥胖成人左心房功能

Evaluation of the left atrial function in simple overweight and obese adults by two-dimensional speckle tracking imaging

目的:研究二维斑点追踪技术(2D-STE)评估单纯超重和肥胖成人左心房局部功能变化的价值。方法:选取2017年1月~2019年1月弋矶山医院体检者单纯超重40例、肥胖30例、正常体质量40例为研究对象。常规测量左心房最小容积(LAVmin)、左心房最大容积(LAVmax)、左心房P容积(LAVp)、二尖瓣口血流舒张早期、晚期峰值流速(V_(E)、V_(A))、心室等容收缩时间(IVCT)、心室等容舒张时间(IVRT)、心室射血时间(VET)、二尖瓣环间隔点、侧壁点舒张早期最大流速(Sep.e′、Lat.e′),并计算V_(E)/V_(A)、Tei指数、V_(E)/Sep.e′和V_(E)/Lat.e′。应用2D-STE依次测出左心房各个壁在左心室舒张晚期、收缩期和舒张早期其基底段、中段和房顶段的平均应变率(mSRa、mSRs、mSRe)。结果:常规测量左心房整体功能所有参数中仅LAPEF 3组间比较差异有统计学意义(P<0.05)。2D-STE测量左心房局部功能所有参数3组间比较仅房间隔及侧壁的基底段和房顶段mSRe差异有统计学意义(P<0.05)。两组之间比较显示对照组和超重组房间隔、侧壁其房顶段mSRe差异有统计学意义(P<0.05);对照组和肥胖组房间隔、侧壁基底段和房顶段mSRe差异有统计学意义(P<0.05);而超重组和肥胖组间比较差异无统计学意义(P>0.05)。结论:2D-STE可评估单纯超重和肥胖成人早期左心房局部功能受损。

Objective:To assess the value of two-dimensional speckle tracking imaging(2 D-STI)in evaluating the changes of the left atrial segment function in adults with simple overweight and obesity.Methods:Forty patients of simple overweight,30 of obesity and 40 of normal weight undergone physical examination in our hospital between January of 2017 and 2019 were included.All subjects underwent conventional measurement of the left atrial minimum volume(LAVmin),left atrial maximum volume(LAVmax),left atrial p volume(LAVp),early diastolic peak velocity(V_(E))at the mitral orifice and late diastolic peak velocity(V_(A)),isovolumic contraction time(IVCT),isovolumic diastolic time(IVRT),ventricular ejection time(VET),point diastolic peak velocity at the lateral wall(Lat.e′)and the early diastolic peak velocity(Sep.e′)of mitral annular septum by tissue Doppler.Then V_(E)/V_(A),Tei index,V_(E)/Sep.e′and V_(E)/Lat.e′were calculated.The mean strain rates(mSRs,mSRe,mSRa)of the left atrial walls in the basal,middle and tip segments of late ventricular diastolic,systolic and early diastolic phases were measured by 2 D-STI.Results:Only LAPEF had significant difference among the three groups(P<0.05).All parameters of local function measured by 2 D-STI were merely significantly different in atrial septum and lateral mSRe among the three groups(P<0.05).There was significant difference between normal weight group and overweight group regarding the atrial septum,lateral mSRe at the basal and tip segment(P<0.05),yet there was no difference between overweight group and obesity group in other parameters(P>0.05).Conclusion:2 D-STI can be used to effectively evaluate the change of left atrial function in adults with simple overweight and obesity.