左心室压力-应变环技术评估妊娠期高血压疾病患者心肌功能

Left ventricular pressure strain loop technique for evaluation on myocardial function in patients with hypertensive disorder complicating pregnancy

目的观察左心室压力-应变环(PSL)技术评估妊娠期高血压疾病(HDP)患者心肌功能的价值。方法前瞻性纳入76例HDP孕妇(妊娠期高血压组,n=40;子痫前期组,n=36)及42名健康孕妇(对照组),比较组间常规超声心动图、PSL参数及左心室整体纵向应变(GLS)的差异;绘制受试者工作特征曲线,评价PSL参数及GLS评估子痫前期孕妇左心室功能的效能。结果妊娠期高血压组和子痫前期组收缩末期左心房内径、室间隔舒张末期厚度、左心室后壁舒张末期厚度、整体做功指数(GWI)、整体有用功(GCW)及整体无用功(GWW)均高于、而GLS及整体做功效率(GWE)均低于对照组(P均<0.05)。妊娠期高血压组GWW低于、而GWE高于子痫前期组(P均<0.05)。GLS、GWI、GCW、GWW及GWE评估子痫前期孕妇左心室功能的曲线下面积分别为0.64、0.69、0.69、0.97及0.67,GWW的评估效能明显优于其他参数(P均<0.05)。结论PSL技术可用于评估各型HDP患者左心室心肌功能改变。

Objective To observe the value of left ventricular pressure strain loop(PSL)technique in evaluating myocardial function of patients with hypertensive disorder complicating pregnancy(HDP).Methods Seventy-six pregnant women with HDP(pregnancy induced hypertension group,n=40;preeclampsia group,n=36)and 42 healthy pregnant women(control group)were prospectively enrolled.Parameters of conventional echocardiography,PSL and global longitudinal strain(GLS)of left ventricle were compared among groups.The receiver operating characteristic curve was drawn to explore the efficacy of PSL parameters and GLS for evaluating left ventricular function in preeclampsia pregnant women.Results In pregnancy induced hypertension group and preeclampsia group,the inner diameter of left atrium,interventricular septal end-diastolic thickness,left ventricular posterior wall end-diastolic thickness,global work index(GWI),global constructive work(GCW)and global wasted work(GWW)were all higher,while GLS and the global work efficiency(GWE)were all lower than those in control group(all P<0.05).In pregnancy induced hypertension group,GWW was lower,while GWE was higher than those in preeclampsia group(both P<0.05).The area under the curve of GLS,GWI,GCW,GWW and GWE for evaluating left ventricular function in preeclampsia pregnant women was 0.64,0.69,0.69,0.97 and 0.67,respectively.GWW had significantly better evaluating efficacy than other parameters(all P<0.05).Conclusion PSL technique could be used to evaluate changes of left ventricular myocardial function in patients with different types HDP.