超声心动图左室压力应变环在高血压所致左心室肥厚与肥厚型心肌病鉴别中的应用

目的探讨超声心动图左室压力应变环在高血压所致左心室肥厚(H-LVH)与肥厚型心肌病(HCM)鉴别中的应用。方法选取2018年11月至2020年12月,在河南郑州中牟县人民医院接受治疗的78例左心室肥厚患者,依据不同病情将患者分为H-LVH组(n=42)与HCM组(n=36),78例患者入院后均接受超声心动图检查,比较两组患者的左心室做功指标、心动图指标、离散程度。结果分析两组患者的检查数据,H-LVH组心肌整体做功指数(GWI)、整体有用功(GCW)和整体做功效率(GWE)均比HCM组高,整体无用功(GWW)比HCM组低(P<0.05);H-LVH组的左房内径(LA)(40.67±5.96)mm、左心室收缩末期左右径(LVsd)(36.98±11.06)mm、左心室舒张末期左右径(LVdd)(50.87±10.14)mm均大于HCM组(44.32±8.21)mm、(29.89±5.67)mm、(44.02±4.91)mm(P<0.05),左室射血分数(LVEF)(51±9)%、室间隔厚度(IVS)(13.26±1.35)mm均小于HCM组(60±6)%、(22.04±6.49)mm(P<0.05);HCM组的最长QT间期(QTmax)、最短QT间期(QTmin)、QT离散度(QTd)均比H-LVH组高(P<0.05);ROC分析显示,GCW、GWW、GWI、GWE、联合检测的AUC分别为0.635、0.673、0.685、0.663、0.657(P<0.05)。结论超声心动图左室压力应变环在H-LVH与HCM的鉴别检查中有重要价值,GCW、GWW、GWI、GWE可以预测患者心肌做功。

Objective To investigate the application of echocardiographic left ventricular strain ring in differentiating hypertension-induced left ventricular hypertrophy(H-LVH)from hypertrophic cardiomyopathy(HCM).Methods A total of 78 patients with left ventricular hypertrophy who received treatment in Zhongmou County People's Hospital of Zhengzhou,Henan province from November 2018 to December 2020 were selected.According to different conditions,the patients were divided into H-LVH group(n=42)and HCM group(n=36).Echocardiography was performed on 78 patients after admission.The left ventricular work index,cardiogram index and dispersion degree were compared between the two groups.Results Analysis of the examination data of the two groups showed that the myocardial global work index(GWI),global constructive work(GCW)and global work efficiency(GWE)of the H-LVH group were higher than those of the HCM group,while the global waste work(GWW)of the H-LVH group was lower than that of the HCM group(P<0.05).The left atrial diameter(LA)(40.67±5.96)mm,left ventricular end systolic left and right diameter(LVsd)(36.98±11.06)mm,left ventricular end diastolic left and right diameter(LVdd)(50.87±10.14)mm in the H-LVH group were higher than those in the HCM group(44.32±8.21)mm,(29.89±5.67)mm,(44.02±4.91)mm(P<0.05);left ventricular ejection fraction(LVEF)(51±9)%and interventricular septal thickness(IVS)(13.26±1.35)mm were lower than those in the HCM group(60±6)%and(22.04±6.49)mm(P<0.05);the maximum QT interval(QTmax),minimum QT interval(QTmin)and QT dispersion(QTd)in the HCM group were higher than those in the H-LVH group(P<0.05);ROC analysis showed that the AUCs of GCW,GWW,GWI,GWE and combined detection were 0.635,0.673,0.685,0.663 and 0.657 respectively(P<0.05).Conclusion Echocardio-graphic left ventricular pressure strain ring is of great value in the differential examination between H-LVH and HCM.GCW,GWW,GWI and GWE can predict myocardial work in patients.