二维斑点追踪在心力衰竭早期合并2型糖尿病患者中的应用

Two Dimensional Speckle Tracking in Patients With Early Heart Failure Combined With Type 2 Diabetes Mellitus

目的探讨二维斑点追踪评价心力衰竭早期合并2型糖尿病患者左心室心肌功能的价值。方法选择2022年1—10月青岛阜外心血管病医院收治的35例2型糖尿病合并早期心力衰竭患者纳入A组,将同期收治的35例2型糖尿病心功能正常患者纳入B组,将于青岛阜外心血管病医院开展健康体检者35名纳入C组。所有纳入研究者均采取心脏超声诊断仪(iE33,EPIQ7C)进行常规超声心动图检测,并运用二维斑点追踪技术(two dimensional speckle tracking echo cardiography,2D-STI)进行追踪分析。采用单因素方差分析法比较三组被检者基线资料、常规超声心动图检测指标、2D-STI参数的差异性。结果三组被检者左房内径(left atrial enlargement,LAD)、左心室收缩期内径(left ventricular end-systolic dimension,LVDs)、左心室舒张期内径(left ventricular end-diastolic dimension,LVDd)、左室后壁厚度(left ventricular posterior wall thickness,LVPWT)、室间隔厚度(interventricular septal thickness,IVST)、左室短轴缩短率(left ventricular fractional shortening,LVFS)、左心室重量指数(left ventricular mass index,LVMI)指标水平比较,均差异无统计学意义(P>0.05);A、B两组患者左心室射血分数(left ventricular ejection fraction,LVEF)差异无统计学意义(P>0.05);C组患者LVEF略高于A、B两组,差异有统计学意义(P<0.05);A组2D-STI成像参数中的纵向应变中间段、基底段、心尖段纵向收缩期峰值应变显著低于B组及C组,各节段均差异有统计学意义(P<0.05);B、C两组2D-STI成像参数中的纵向应变中间段、基底段、心尖段纵向收缩期峰值应变差异无统计学意义(P>0.05);三组2D-STI成像参数中的径向应变和圆周应变比较,均差异无统计学意义(P>0.05)。结论2D-STI技术在心力衰竭早期合并2型糖尿病患者左心室心肌功能评价中具有重要的价值,能够在左室收缩功能降低前发现已经存在的左室纵向心肌功能损害,为临床诊疗提供重要的参考。

Objective To explore the value of two dimensional speckle tracking in evaluating left ventricular myocardial function in patients with early heart failure and type 2 diabetes.Methods A total of 35 patients with type 2 diabetes combined with early heart failure admitted to Qingdao Fuwai Cardiovascular Hospital from January to October 2022 were included in group A,35 cases of type 2 diabetes patients with normal cardiac function admitted at the same time were included in group B,and 35 cases of health examination conducted in Qingdao Fuwai Cardiovascular Hospital were included in group C.All enrolled researchers underwent routine echocardiography using iE33 and EPIQ7C echocardiography,and were followed up and analyzed using two dimensional speckle tracking echo cardiography(2D-STI).Use one-way analysis of variance to compare the differences in baseline data,conventional echocardiographic detection indicators,and 2D-STI parameters among three groups of subjects.Results There was no statistically significant difference in the levels of left atrial enlargement(LAD),left ventricular end-systolic dimension(LVDs),left ventricular end-diastolic dimension(LVDd),left ventricular posterior wall thickness(LVPWT),interventricular septal thickness(IVST),left ventricular fractional shortening(LVFS),and left ventricular mass index(LVMI)indicators among the three groups of subjects(P>0.05).There was no significant difference in left ventricular ejection fraction(LVEF)index levels between group A and group B(P>0.05).The LVEF of group C patients was slightly higher than that of groups A and B,with statistical significance(P<0.05).The peak longitudinal systolic strain in the middle,basal,and apical segments of group A's 2D-STI imaging parameters was significantly lower than that in group B and C,with statistical differences in each segment(P<0.05).There was no statistically significant difference in the longitudinal peak systolic strain of the mid segment,basal segment,and apical segment in the 2D-STI imaging parameters between the two groups C(P>0.05).There was no statistically significant difference in the radial strain and circumferential strain among the three sets of 2D-STI imaging parameters(P>0.05).Conclusion 2D-STI technology has important value in the evaluation of left ventricular myocardial function in patients with early heart failure and type 2 diabetes.It can find the existing left ventricular longitudinal myocardial function damage before the left ventricular systolic function decreases,which provides an important reference for clinical diagnosis and treatment.