左心室压力应变曲线评估左心室充盈异常患者心肌做功

Left ventricular pressure-strain curve for evaluating myocardial work of patients with abnormal left ventricular filling

目的观察左心室压力应变曲线评估左心室充盈异常患者心肌做功的价值。方法将85例左心室充盈异常患者分为松弛性减退组(n=28)、假性正常化组(n=30)和限制性充盈异常组(n=27);以同期30名健康志愿者为对照组。比较各组一般资料、左心常规超声参数[左心室舒张末期内径(LVEDD)、左心房前后径(LAD)、二尖瓣口舒张早期和晚期血流峰值速度比值(E/A)、二尖瓣舒张早期和晚期峰值速度比值(Ea/Aa)、左心室舒张末期容积(LVEDV)、左心室收缩末期容积(LVESV)、左心室射血分数(LVEF)]及左心室心肌做功参数[整体纵向应变(GLS)、整体无用功(GWW)、整体做功效率(GWE)、整体有用功(GCW)及整体做功指数(GWI)],分析其心肌做功。结果对照组LVEDD、LVEDV、LVESV及LAD均低于、而LVEF高于假性正常化组和限制性充盈异常组(P均<0.05);对照组E/A高于松弛性减退组且低于限制性充盈异常组(P均<0.05),而Ea/Aa均高于其他3组(P均<0.05)。松弛性减退组LVEDD、LVEDV、LVESV、LAD及E/A均低于、而LVEF高于假性正常化组(P均<0.05);松弛性减退组Ea/Aa低于限制性充盈异常组(P<0.05);假性正常化组LVEDD、LVEDV、LVESV、LAD及E/A均低于、而LVEF高于限制性充盈异常组(P均<0.05)。对照组GWW低于、而GLS、GWI、GCW和GWE均高于松弛性减退组(P均<0.05);松弛性减退组GWW低于、而GLS、GWI、GCW和GWE均高于假性正常化组(P均<0.05);假性正常化组GWW低于、而GLS、GWI、GCW和GWE均高于限制性充盈异常组(P均<0.05)。结论左心室压力应变曲线评估左心室充盈异常患者左心室心肌做功价值较高。

Objective To observe the value of left ventricular pressure-strain curve for evaluating myocardial work of patients with abnormal left ventricular filling.Methods Totally 85 patients with abnormal left ventricular filling were enrolled and divided into laxity decrudescence group(n=28),pseudo normalization group(n=30)and restrictive filling dysfunction group(n=27).Meanwhile,30 healthy volunteers were selected as controls(control group).The general data,conventional left ventricular ultrasound parameters(left ventricular end-diastolic dimension[LVEDD],left atrium diameter[LAD],ratio of early and late diastolic blood flow peak velocity of mitral valve orifice[E/A],ratio of mitral annulus early and late diastole peak velocity[Ea/Aa],left ventricular end-diastolic volume[LVEDV],left ventricular end-systolic volume[LVESV]and left ventricular ejection fraction[LVEF]),as well as left ventricular myocardial work parameters(global longitudinal strain[GLS],global wasted work[GWW],global work efficiency[GWE],global constructive work[GCW]and global work index[GWI])were compared to analyze the myocardial work among groups.Results LVEDD,LVEDV,LVESV and LAD of control group were lower but LVEF was higher than those of pseudo normalization group and restrictive filling dysfunction group(all P<0.05),while E/A was higher than that of laxity decrudescence group but lower than that of restrictive filling dysfunction group(both P<0.05),Ea/Aa was higher than that of other 3 groups(P<0.05).LVEDD,LVEDV,LVESV,LAD and E/A of laxity decrudescence group were lower but LVEF was higher than that of pseudo normalization group(all P<0.05),while Ea/Aa was lower than that of restrictive filling dysfunction group(P<0.05).LVEDD,LVEDV,LVESV,LAD and E/A of pseudo normalization group were lower but LVEF was higher than that of restrictive filling dysfunction group(all P<0.05).GWW of control group was lower but GLS,GWI,GCW and GWE were higher than those of laxity decrudescence group(all P<0.05).GWW of laxity decrudescence group were lower but GLS,GWI,GCW and GWE were higher than those of pseudo normalization group(all P<0.05).GWW of pseudo normalization group was lower but GLS,GWI,GCW and GWE were higher than those of restrictive filling dysfunction group(all P<0.05).Conclusion Left ventricular pressure-strain curve was valuable for evaluating left ventricular myocardial work in patients with abnormal left ventricular filling.