力量型运动员左心房前后径与四维自动左心房定量功能参数的相关性

Correlation Between Left Atrial Diameter and Four-Dimensional Automatic Left Atrial Quantitation Function Parameters in Power Athletes

目的探讨四维自动左心房定量(4D LAQ)分析技术对力量型运动员左心房形态和功能评价及其与左心房前后径(LAD)的相关性。资料与方法收集2013年9月—2021年7月于河南省重竞技体育管理中心参加专业训练的男性力量型运动员50例,选取郑州大学第一附属医院同期体检的健康男青年30例作为对照组,采用常规超声心动图测得两组LAD、左心室舒张末期内径(LVEDd)、室间隔厚度(IVSTd)和左心室后壁厚度(PWTd),并计算相对室壁厚度(RWT)、左心房射血分数(LAEF)和左心室质量指数(LVMI),应用4D LAQ自动分析两组左心房储蓄期纵向应变(LASr)、左心房导管期纵向应变(LAScd)、左心房辅泵期纵向应变(LASct)、左心房储蓄期圆周应变(LASr-c)、左心房导管期圆周应变(LAScd-c)、左心房辅泵期圆周应变(LASct-c)、左心房最小容积(LAVmin)、左心房最大容积(LAVmax)、左心房收缩前容积(LAVpre-A)和左心房容积指数(LAVI),计算左心房主动射血分数(LAAEF)及左心房扩张指数(LAEI),分析LAD与LASr、LAScd、LASct、LASr-c、LAScd-c、LASct-c、LAEF、LAAEF、LAEI及LAVI的相关性,并计算简单回归方程。结果与对照组比较,运动员组LAD、LVEDd、IVSTd、PWTd、RWT、LVMI较大(t=2.422~15.152,P<0.05),左心房各时相容积较大(t=8.219~10.278,P<0.01),LAEI、LAEF、LAAEF较低(t=-5.046~-2.926,P<0.01),4D LAQ分析得到的左心房应变参数均较低(t=-3.162~3.980,P<0.05)。LAD与LAScd、LASct、LASct-c、LAVI呈正相关(r=0.168、0.328、0.299、0.663,P<0.05),与LASr、LAAEF呈负相关(r=-0.280、-0.259,P<0.05)。LAD与LASr-c、LAScd-c、LAEF、LAEI无相关性(P<0.05)。LAD(X)与LASr(Y1/%)、LAScd(Y2/%)、LASct(Y3/%)、LASct-c(Y4/%)、LAAEF(Y5/%)、LAVI(Y6/%)的简单回归方程分别为:Y1=33.465-0.321X,Y2=-20.084+0.133X,Y3=-14.153+0.221X,Y4=-20.554+0.314X,Y5=39.826-0.371X,Y6=-6.211+0.935X。结论4D LAQ技术可提示力量型运动员LAD、IVST、LVEDD、LVMI,左心房各时相容积明显增加,LAEF、LAAEF降低,并且运动员中4D LAQ分析获得的参数LASr、LAScd、LASct、LASr-c、LAScd-c、LASct-c均低于正常人,LAD与LASr、LAScd、LASct、LASct-c、LAAEF、LAVI具有相关性且存在定量关系,可用于早期评价力量型运动员的左心房功能。

Purpose To explore the evaluation of left atrial morphology and function as well as its correlation with left atrial diameter(LAD)in power athletes via four-dimensional automatic left atrial quantitation(4D LAQ)analysis technique.Materials and Methods Fifty cases of male strength athletes who participated in professional training at Henan Heavy Sports Management Center from September 2013 to July 2021 were collected,and thirty healthy males from the First Affiliated Hospital of Zhengzhou University were selected as the control group at the same time.LAD,left ventricular end-diastolic internal diameter(LVEDd),interventricular septal thickness(IVSTd),posterior wall thickness of the left ventricle(PWTd)in both groups were measured via conventional echocardiography,relative chamber wall thickness(RWT),left atrial ejection fraction(LAEF)and left ventricular mass index(LVMI)were calculated.4D LAQ was applied to automatically analyze the longitudinal strain in the left atrial reservoir longitudinal strain(LASr),left atrial conduit longitudinal strain(LAScd),left atrial contraction longitudinal strain(LASct),circumferential strain in the left atrial savings phase(LASr-c),circumferential strain in the left atrial conduit phase(LAScd-c),left atrial reservoir circumferential strain(LASct-c),left atrial minimal atrial volume(LAVmin),left atrial maximum atrial volume(LAVmax),left atrial volume before atrial contraction(LAVpre-A)and left atrial volume index(LAVI)in both groups.The left atrial active ejection fraction(LAAEF)and the left atrial expansion index(LAEI)were calculated.The correlations between LAD and LASr,LAScd,LASct,LASr-c,LAScd-c,LASct-c,LAEI,LAEF,LAAEF as well as LAVI respectively and simple regression equations were calculated.Results Compared with control group,the athlete group showed significant increases in LAD,LVEDd,IVSTd,PWTd,RWT and LVMI(t=2.422-15.152,P<0.05),significant increases in LA volumes in all time phases(t=8.219-10.278,P<0.01),significant decreases in LAEI,LAEF and LAAEF(t=-5.046--2.926,P<0.01),and significant decreases in all left atrial strain parameters obtained by 4D LAQ analysis(t=-3.162-3.980,P<0.05).LAD was positively correlated with LAScd,LASct,LASct-c and LAVI(r=0.168,0.328,0.299,0.663;P<0.05),and it was negatively correlated with LASr and LAAEF(r=-0.280,-0.259;P<0.05).LAD showed no correlation with LASr-c,LAScd-c,LAEF and LAEI(P<0.05).Simple regression equations for LAD(X)and LASr(Y1/%),LAScd(Y2/%),LASct(Y3/%),LASct-c(Y4/%),LAAEF(Y5/%),LAVI(Y6/%)were Y1=33.465-0.321X,Y2=-20.084+0.133X,Y3=-14.153+0.221X,Y4=-20.554+0.314X,Y5=39.826-0.371X and Y6=-6.211+0.935X.Conclusion 4D LAQ technique can suggest significant increases in LAD,IVST,LVEDD,LVMI,left atrium volume in each temporal phase and decreases in LAEF and LAAEF in power athletes compared with control group,and the parameters including LASr,LAScd,LASct,LASr-c,LAScd-c,LASct-c obtained from 4DLAQ analysis are lower in the athlete group than those in control group and LAD has significant correlations and quantitative relationships with LASr,LAScd,LASct,LASct-c,LAAEF and LAVI,respectively,which can be used for early evaluation of left atrial function in strength athletes.