TTE联合3D-STI评价启闭功能正常的BAV患者升主动脉弹性与左室收缩功能

To evaluate the elasticity of ascending aorta and left ventricular systolic function in BAV patients with normal opening and closing function by transthoracic echocardiography combined with three-dimensional speckle tracking imaging

目的应用经胸超声心动图(TTE)联合三维斑点追踪成像技术(3D-STI)评价启闭功能正常的主动脉瓣二叶式畸形(BAV)患者升主动脉弹性与左室收缩功能并探讨两者之间的相关性。方法选取启闭功能正常的BAV患者60例,正常人60例为对照组。常规采用经胸超声心动图测量升主动脉收缩末期(AoS)及舒张末期内径(AoD)、室间隔舒张末期(IVSD)及左室后壁舒张末期厚度(LVPWD)、左室射血分数(LVEF)等参数,公式计算升主动脉应变(Aortic strain)、升主动脉僵硬指数(AoSI)、升主动脉扩张性(AoDIS);应用三维斑点追踪成像技术获取左室整体纵向应变(GLS)、左室整体圆周应变(GCS)、左室整体径向应变(GRS),比较BAV组与对照组各参数的差异,探求BAV组升主动脉弹性与左室收缩功能的关联性。结果BAV组AoS、AoD、AoSI值高于对照组,Aortic strain、AoDIS值低于对照组(P<0.05),LVEF值差异无统计学意义(P>0.05);GLS、GCS和GRS与对照组比较明显减低(P<0.05)。BAV组左室GLS、GCS、GRS与Aortic strain、AoSI、AoDIS无相关性。结论启闭功能正常的BAV患者升主动脉弹性与左室收缩功能均减低,两者之间无明显相关性。

Objective To evaluate the ascending aorta elasticity and left ventricular systolic function in bicuspid aortic valve(BAV)patients with normal opening and closing function by transthoracic echocardiography(TTE)combined with three-dimensional speckle tracking imaging(3D-STI),and to explore the correlation between them.Methods 60 BAV patients with normal function and 60 healthy controls were enrolled in this study.Transthoracic echocardiography was used to measure the end-systolic(AoS)and end-diastolic diameter(AoD)of the ascending aorta,end-diastolic interventricular septum(IVSD),left ventricular posterior wall end-diastolic thickness(LVPWD),and left ventricular ejection fraction(LVEF).The ascending Aortic strain,ascending aortic stiffness index(AoSI)and ascending aortic distensibility(AoDIS)were calculated.The left ventricular global longitudinal strain(GLS),left ventricular global circumferential strain(GCS)and left ventricular global radial strain(GRS)were analyzed by three-dimensional speckle tracking imaging.The differences of parameters between BAV group and control group were compared,and the correlation between ascending aorta elasticity and left ventricular systolic function in BAV group was explored.Results The AoS,AoD and AoSI in the BAV group were higher than those in the control group,and Aortic strain and AoDIS were lower than those in the control group(P<0.05),LVEF had no significant difference(P>0.05).GLS,GCS and GRS were significantly lower than those in the control group(P<0.05).There was no correlation between GLS、GCS、GRS and Aortic strain,AoSI,AoDIS in BAV group.Conclusion The ascending aorta elasticity and left ventricular systolic function are decreased in BAV patients with normal opening and closing function,and there is no significant correlation between them.