无创左心室压力-应变环技术评估甲亢患者的左心室收缩功能

Evaluation of left ventricular systolic function in patients with hyperthyroidism by non-invasive left ventricular pressure-strain loop technology

目的 探讨应用无创左心室压力-应变环(LV-PSL)技术评估甲状腺功能亢进症(甲亢)患者的左心室收缩功能的价值。方法 选取91例甲亢患者,根据是否接受过治疗分为初诊组(49例)及治疗组(42例),并纳入健康志愿者(40例)作为对照组。应用常规超声心动图获取相关参数,斑点追踪技术获取整体纵向应变(GLS),无创LV-PSL技术获取整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE),比较上述三组参数的差异。分析收缩压(SBP)、心率(HR)与GLS、GWI、GCW、GWW、GWE的相关性。结果 与对照组比较,初诊组和治疗组HR、主动脉舒张末期(AOEDD)、GWW均增高,而GLS、GWI、GWE均降低;且初诊组SBP增高,而GCW降低,差异具有统计学意义(P<0.05)。与初诊组比较,治疗组SBP、HR、GWW降低,而GWE增高,差异具有统计学意义(P<0.05)。相关性分析显示SBP与GWW呈正相关(r=0.277,P<0.01);与GLS、GWE呈负相关(r=-0.271、-0.259,P<0.01);HR与GLS、GWE呈负相关(r=-0.220、-0.185,P<0.05),与GWI、GCW也呈负相关(r=-0.447、-0.353, P<0.01)。结论 无创LV-PSL技术可早期定量评估甲亢患者左心室收缩功能,为临床早期预测、早期干预及治疗效果评估提供参考价值,治疗后甲亢患者左心室收缩功能可恢复。

Objective To evaluate the left ventricular systolic function in patients with hyperthyroidism by non-invasive left ventricular pressure-strain loop(LV-PSL)technology.Methods 91 patients with hyperthyroidism were enrolled in this study.The patients were then categorized into two groups:the initial diagnosis group(n=49)and the treatment group(n=42)based on whether treated or not.Additionally,healthy volunteers were included as the control group(n=40).Relevant parameters were assessed using conventional echocardiography,global longitudinal strain(GLS)was measured using speckle tracking technology,and the global work index(GWI),global constructive work(GCW),global wasted work(GWW),and global work efficiency(GWE)were obtained using LV-PSL technology.Statistical analysis was performed to compare the parameters among the three groups.Finaly,we analyzed the correlation between SBP,HR and GLS,GWI,GCW,GWW,and GWE.Results Compared with the control group,HR,AOEDD,and GWW were increased in both the initial diagnosis and treatment groups,while GLS,GWI,and GWE were decreased;and SBP was increased in the initial diagnosis group,while GCWwas decreased.The differences were statistically significant(P<0.05).Compared with the initial diagnosis group,SBP,HR and GWW were decreased in the treatment group,while GWE was increased,the differences were statistically significant(P<0.05).Correlation analysis showed that SBP was positively correlated with GWW(r=0.277,P<0.01),SBP was negatively correlated with GLS and GWE(r=-0.271、-0.259,P<0.01);HR was negatively correlated with GLS and GWE(r=-0.220,-0.185,P<0.05),and also negatively correlated with GWI and GCW(r=-0.447,-0.353,P<0.01).Conclusion Non-invasive LV-PSL technology can quantitatively evaluate left ventricular systolic function in patients with hyperthyroidism in the early stage and provide reference value for clinical early prediction,early intervention,and efficacy evaluation.After treatment,the left ventricular systolic function of patients with hyperthyroidism can be restored.