二维斑点追踪成像技术评价COPD患者右心室功能及其与肺动脉硬化度的相关性

Evaluation of Right Ventricular Function and Its Correlation with Pulmonary Artery Stiffness by Two-dimensional Speckle Tracking Imaging in COPD Patients

目的:探讨应用二维斑点追踪成像技术(2D-STI)评价慢性阻塞性肺疾病(COPD)右心室功能及其和肺动脉硬化度(PAS)的相关性。方法:病例组纳人2020年11月至2021年11月就诊于宁夏医科大学总医院的42例COPD患者,同期选取32例正常人作为对照组。采集并比较2组之间的右心室整体、游离壁及室间隔的基底段、中间段和心尖段的峰值纵向应变值,另外再比较2组间的肺动脉最大流速(PvO)、肺血流加速时间(PAT)、肺血流最大频移(MFS)及PAS。采用Pearson相关分析,分析COPD患者右心室二维斑点应变值与其肺动脉硬化度的相关性。结果:①COPD组PvO、MFS及PAS均显著高于对照组,而PAT显著低于对照组(P<0.05)。②与对照组相比,COPD组右心室整体峰值纵向应变、游离壁基底段、游离壁中间段、游离壁心尖段、室间隔基底段、室间隔中间段及室间隔心尖段峰值纵向应变均显著降低(P<0.05)。③PAS与右心室整体峰值纵向应变、游离壁基底段、游离壁中间段、游离壁心尖段、室间隔基底段、室间隔中间段、室间隔心尖段峰值纵向应变均存在显著负相关(r=-0.608、-0.486、-0.476、-0.309、-0.535、-0.449、-0.388,均P<0.05)。结论:2D-STI技术可以发现COPD患者亚临床右心室功能障碍;COPD患者PAS升高,且与右心室整体及各节段峰值纵向应变均呈负相关关系,说明PAS可能与COPD患者的亚临床右心室功能异常相关。

Purpose:To investigate the correlation between the right ventricular(RV)function evaluated by twodimensional speckle tracking imaging(2D-STI)and pulmonary arterial stiffness(PAS)in patients with chronic obstructive pulmonary disease(COPD).Methods:Forty-two COPD patients in the General Hospital of Ningxia Medical University from November 2020 to November 2021 were included as the case group;and 32 normal subjects were selected as the control group in the same period.The global RV peak longitudinal strain,and the segmental peak longitudinal strain values of the base,middle and apical segments of the RV free wall and interventricular septum were collected and compared;the pulmonary artery maximum flow velocity(PvO),pulmonary flow acceleration time(MFS)and PAS were also compared between the two groups.The Pearson correlation analysis was used to analyze the correlation between the 2D RV strain values and parameters of pulmonary arteriosclerosis in patients with COPD.Results:①Pvo,MFS and PAS of the patients in case group were significantly higher than those in the control group,while PAT was significantly lower than that in the control group(P<0.05).②Compared with the control group,the global RV peak longitudinal strain,the peak longitudinal strains in the base,middle and apical segments of RV free wall,peak longitudinal strains in the basal,middle and apical segments of the septum were significantly decreased in the COPD group(P<0.05).③PAS showed a significant negative correlation with the global RV longitudinal strain and longitudinal strains of each segments(r=-0.608,-0.486,-0.476,-0.309,-0.535,-0.449,-0.388,all P<0.05).Conclusion:2D-STI technique could detect subclinical RV dysfunction in COPD patients;PAS was increased in COPD patients,and showed negative correlation with the global and segmental RV peak longitudinal strain,indicating that PAS might has adverse influence on the RV function in COPD patients.