Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (...Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Method: From July 2016 to December 2018, 86 patients with OSAS were selected as OSAS group. According to sleep apnea hypopnea index (AHI), they were divided into mild OSAS group (24 cases), moderate OSAS group (29 cases) and severe OSAS group (33 cases). Another 50 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The results of routine echocardiography and left ventricular global strain parameters of the OSAS group, the control group and the OSAS patients with different severity were compared and analyzed. Result: There were no significant differences in the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) between the two groups and OSAS patients with different severity (P>0.05). The levels of IVST, LVPW and LVMI in the OSAS group were significantly higher than those in the control group, the levels of end-diastolic interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass index (LVMI) in the severe OSAS group were significantly higher than those in the mild and moderate OSAS group, and the levels of IVST, LVPW and LVMI in the moderate OSAS group were significantly higher than those in the mild OSAS group, there were significant differences between groups (P<0.05). The levels of GLS, GRS and GCS in the OSAS group were significantly lower than those in the control group (P<0.05). GLS, GRS and GCS levels in the severe OSAS group were significantly lower than those in the mild OSAS group and the moderate OSAS group, while the levels of global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) in the moderate OSAS group were significantly lower than those in the mild OSAS group (P<0.05). Conclusion: The left ventricular systolic function of OSAS patients is obviously impaired. Left ventricular function in OSAS patients can be assessed timely and accurately by two-dimensional speckle tracking imaging.展开更多
目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(...目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(Chronic heart failure,CHF)患者心功能评价中的应用价值。方法选取2020年1月至2022年4月重庆大学附属沙坪坝医院重庆市沙坪坝区人民医院心血管内科收治的老年CHF患者167例设为研究组,另选取同期健康体检者167例设为对照组。采集两组受检者性别、年龄、体质量指数(Body mass index,BMI)、舒张压、收缩压、研究组美国纽约心脏病学会(New York Heart Association,NYHA)分级等资料,实施3D-STI、4DAutoVQ检查。比较研究组与对照组、研究组不同NYHA分级患者4DAutoVQ、3D-STI参数,分析4DAutoVQ、3D-STI参数与研究组NYHA分级的关联性。结果(1)研究组左心室整体径向收缩期峰值应变(Global radial systolic peak strain of left ventricle,GRS)、整体环向收缩期峰值应变(Global circumferential peak systolic strain,GCS)、整体纵向收缩期峰值应变(Overall longitudinal peak systolic strain,GLS)、左房排空容积(Left atrial emptying volume,LAEV)、左房射血分数(Left atrial ejection fraction,LAEF)、左房被动射血分数(Left atrial passive ejection fraction,LAPEF)、左房主动射血分数(Left atrial active ejection fraction,LAAEF)、左房储备期纵向应变(Longitudinal strain of left atrial reserve,LASr)、左房储备期圆周应变(Peripheral strain of left atrial reserve period,LASr-c)低于对照组,左房最大容积指数(Maximum left atrial volume index,LAVImax)、左房最小容积(Minimum left atrial volume,LAVmin)、左房收缩前容积(Left atrial pre systolic volume,LAVpreA)、左房最大容积(Maximum left atrial volume,LAVmax)、左房通道期纵向应变(Longitudinal strain of left atrial passage,LAScd)、左房收缩期纵向应变(Longitudinal strain of left atrium during systole,LASct)、左房收缩期圆周应变(Left atrial systolic circumferential strain,LASct-c)、左房通道期圆周应变(Circumferential strain of left atrial passage,LAScd-c)高于对照组,差异有统计学意义(P<0.05)。(2)研究组不同NYHA分级患者4DAutoVQ、3D-STI参数比较,差异有统计学意义(P<0.05),且随着NYHA分级增高,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c呈降低趋势,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c呈增高趋势,差异有统计学意义(P<0.05)。(3)Spearman相关性分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c与CHF病情分级存在负相关关系,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c与CHF病情分级存在显著正相关关系(P<0.05)。(4)Logistic分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c、LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c均是CHF重要影响因素(P<0.05)。结论通过4DAutoVQ、3D-STI检查可评估老年CHF患者心功能及结构状态,相关参数增高或降低程度与疾病病情关系密切,可评估疾病NYHA分级。展开更多
目的 应用二维斑点追踪成像(two-dimensional speckle tracking imaging,2D-STI)和超声极速成像技术分别检测左心房壁心肌应变率参数和颈动脉弹性参数,评价H型高血压对糖尿病肾病患者左心房及颈动脉功能的影响。方法 收集2019年9月至202...目的 应用二维斑点追踪成像(two-dimensional speckle tracking imaging,2D-STI)和超声极速成像技术分别检测左心房壁心肌应变率参数和颈动脉弹性参数,评价H型高血压对糖尿病肾病患者左心房及颈动脉功能的影响。方法 收集2019年9月至2021年6月西安医学院第三附属医院就诊的糖尿病肾病患者136例,根据指南标准分为单纯高血压组53例及H型高血压组83例,选择同期健康受试者50例作为健康对照组。收集所有受试者常规超声心动图及多普勒超声检查参数。应用2D-STI计算左心房壁心肌应变率参数[左心房收缩期平均纵向峰值应变率(mean peak longitudinal strain rate of left atrium in systolic phase,mSRs),左心房舒张晚期平均峰值纵向应变率(mean peak longitudinal strain rate of left atrium in late-diastolic phase,mSRa),左心房舒张早期平均峰值纵向应变率(mean peak longitudinal strain rate of left atrium in early-diastolic phase,mSRe)]。超声极速成像技术检测颈动脉弹性相关参数[内-中膜厚度(intima-media thickness,IMT),收缩早期脉搏波传导速度(beginning of the systole PWV,BS-PWV),收缩晚期脉搏波传导速度(end of the systole PWV,ES-PWV)]。Pearson相关性分析左心房壁心肌应变率参数与颈动脉弹性参数间的相关性。结果 单纯高血压组和H型高血压组BMI、糖化血红蛋白浓度及收缩压、舒张压均高于健康对照组(P<0.05)。单纯高血压组和H型高血压组的左心房前后径(left atrial diameters,LAD),二尖瓣口舒张早期血流速度峰值与二尖瓣环根部运动速度峰值比(E/e’)均高于健康对照组(P<0.05),单纯高血压组LAD低于H型高血压组(P<0.05)。单纯高血压组和H型高血压组mSRs、mSRe均低于健康对照组,且H型高血压组mSRs、mSRe低于单纯高血压组(P<0.05)。单纯高血压组和H型高血压组IMT、BS-PWV及ES-PWV均高于健康对照组(P<0.05);H型高血压组的IMT、BS-PWV及ES-PWV均高于单纯高血压组(P<0.05)。结论 相比健康人群,糖尿病肾病患者左心房和颈动脉功能明显发生损害,其中合并H型高血压的患者功能损害更加明显,且与颈动脉硬化及左心房功能损害具有相关性,提示H型高血压能加剧糖尿病肾病患者左心房及颈动脉功能损害。展开更多
This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respira...This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respiratory maneuvers such as quiet breathing,voluntary sniffing and deep inspiration.On the zone of apposition to the rib cage for both hemidiaphragms,it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration.These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction.These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases.Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.展开更多
文摘Objective: To research the clinical application of two-dimensional speckle tracking imaging (2D-STI) in quantitative assessment of left ventricular function in patients with obstructive sleep apnea-hypopnea syndrome (OSAS). Method: From July 2016 to December 2018, 86 patients with OSAS were selected as OSAS group. According to sleep apnea hypopnea index (AHI), they were divided into mild OSAS group (24 cases), moderate OSAS group (29 cases) and severe OSAS group (33 cases). Another 50 healthy volunteers who underwent physical examination in our hospital during the same period were selected as the control group. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The left ventricular function of all patients was quantitatively assessed by 2D-STI. The results of routine echocardiography and left ventricular global strain parameters of the OSAS group, the control group and the OSAS patients with different severity were compared and analyzed. Result: There were no significant differences in the levels of left ventricular ejection fraction (LVEF), left ventricular end diastolic diameter (LVEDd), left ventricular end systolic diameter (LVESd) between the two groups and OSAS patients with different severity (P>0.05). The levels of IVST, LVPW and LVMI in the OSAS group were significantly higher than those in the control group, the levels of end-diastolic interventricular septal thickness (IVS), left ventricular posterior wall thickness (LVPW), left ventricular mass index (LVMI) in the severe OSAS group were significantly higher than those in the mild and moderate OSAS group, and the levels of IVST, LVPW and LVMI in the moderate OSAS group were significantly higher than those in the mild OSAS group, there were significant differences between groups (P<0.05). The levels of GLS, GRS and GCS in the OSAS group were significantly lower than those in the control group (P<0.05). GLS, GRS and GCS levels in the severe OSAS group were significantly lower than those in the mild OSAS group and the moderate OSAS group, while the levels of global longitudinal strain (GLS), global radial strain (GRS) and global circumferential strain (GCS) in the moderate OSAS group were significantly lower than those in the mild OSAS group (P<0.05). Conclusion: The left ventricular systolic function of OSAS patients is obviously impaired. Left ventricular function in OSAS patients can be assessed timely and accurately by two-dimensional speckle tracking imaging.
文摘目的探讨四维超声自动左心房定量技术(Automatic left atrial quantification with four-dimensional ultrasound,4DAutoVQ)、三维斑点追踪成像技术(Three-dimensional speckle tracking imaging technology,3D-STI)在老年慢性心力衰竭(Chronic heart failure,CHF)患者心功能评价中的应用价值。方法选取2020年1月至2022年4月重庆大学附属沙坪坝医院重庆市沙坪坝区人民医院心血管内科收治的老年CHF患者167例设为研究组,另选取同期健康体检者167例设为对照组。采集两组受检者性别、年龄、体质量指数(Body mass index,BMI)、舒张压、收缩压、研究组美国纽约心脏病学会(New York Heart Association,NYHA)分级等资料,实施3D-STI、4DAutoVQ检查。比较研究组与对照组、研究组不同NYHA分级患者4DAutoVQ、3D-STI参数,分析4DAutoVQ、3D-STI参数与研究组NYHA分级的关联性。结果(1)研究组左心室整体径向收缩期峰值应变(Global radial systolic peak strain of left ventricle,GRS)、整体环向收缩期峰值应变(Global circumferential peak systolic strain,GCS)、整体纵向收缩期峰值应变(Overall longitudinal peak systolic strain,GLS)、左房排空容积(Left atrial emptying volume,LAEV)、左房射血分数(Left atrial ejection fraction,LAEF)、左房被动射血分数(Left atrial passive ejection fraction,LAPEF)、左房主动射血分数(Left atrial active ejection fraction,LAAEF)、左房储备期纵向应变(Longitudinal strain of left atrial reserve,LASr)、左房储备期圆周应变(Peripheral strain of left atrial reserve period,LASr-c)低于对照组,左房最大容积指数(Maximum left atrial volume index,LAVImax)、左房最小容积(Minimum left atrial volume,LAVmin)、左房收缩前容积(Left atrial pre systolic volume,LAVpreA)、左房最大容积(Maximum left atrial volume,LAVmax)、左房通道期纵向应变(Longitudinal strain of left atrial passage,LAScd)、左房收缩期纵向应变(Longitudinal strain of left atrium during systole,LASct)、左房收缩期圆周应变(Left atrial systolic circumferential strain,LASct-c)、左房通道期圆周应变(Circumferential strain of left atrial passage,LAScd-c)高于对照组,差异有统计学意义(P<0.05)。(2)研究组不同NYHA分级患者4DAutoVQ、3D-STI参数比较,差异有统计学意义(P<0.05),且随着NYHA分级增高,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c呈降低趋势,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c呈增高趋势,差异有统计学意义(P<0.05)。(3)Spearman相关性分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c与CHF病情分级存在负相关关系,LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c与CHF病情分级存在显著正相关关系(P<0.05)。(4)Logistic分析结果显示,GRS、GCS、GLS、LAEV、LAEF、LAPEF、LAAEF、LASr、LASr-c、LAVImax、LAVmin、LAVpreA、LAVmax、LAScd、LASct、LASct-c、LAScd-c均是CHF重要影响因素(P<0.05)。结论通过4DAutoVQ、3D-STI检查可评估老年CHF患者心功能及结构状态,相关参数增高或降低程度与疾病病情关系密切,可评估疾病NYHA分级。
文摘目的 应用二维斑点追踪成像(two-dimensional speckle tracking imaging,2D-STI)和超声极速成像技术分别检测左心房壁心肌应变率参数和颈动脉弹性参数,评价H型高血压对糖尿病肾病患者左心房及颈动脉功能的影响。方法 收集2019年9月至2021年6月西安医学院第三附属医院就诊的糖尿病肾病患者136例,根据指南标准分为单纯高血压组53例及H型高血压组83例,选择同期健康受试者50例作为健康对照组。收集所有受试者常规超声心动图及多普勒超声检查参数。应用2D-STI计算左心房壁心肌应变率参数[左心房收缩期平均纵向峰值应变率(mean peak longitudinal strain rate of left atrium in systolic phase,mSRs),左心房舒张晚期平均峰值纵向应变率(mean peak longitudinal strain rate of left atrium in late-diastolic phase,mSRa),左心房舒张早期平均峰值纵向应变率(mean peak longitudinal strain rate of left atrium in early-diastolic phase,mSRe)]。超声极速成像技术检测颈动脉弹性相关参数[内-中膜厚度(intima-media thickness,IMT),收缩早期脉搏波传导速度(beginning of the systole PWV,BS-PWV),收缩晚期脉搏波传导速度(end of the systole PWV,ES-PWV)]。Pearson相关性分析左心房壁心肌应变率参数与颈动脉弹性参数间的相关性。结果 单纯高血压组和H型高血压组BMI、糖化血红蛋白浓度及收缩压、舒张压均高于健康对照组(P<0.05)。单纯高血压组和H型高血压组的左心房前后径(left atrial diameters,LAD),二尖瓣口舒张早期血流速度峰值与二尖瓣环根部运动速度峰值比(E/e’)均高于健康对照组(P<0.05),单纯高血压组LAD低于H型高血压组(P<0.05)。单纯高血压组和H型高血压组mSRs、mSRe均低于健康对照组,且H型高血压组mSRs、mSRe低于单纯高血压组(P<0.05)。单纯高血压组和H型高血压组IMT、BS-PWV及ES-PWV均高于健康对照组(P<0.05);H型高血压组的IMT、BS-PWV及ES-PWV均高于单纯高血压组(P<0.05)。结论 相比健康人群,糖尿病肾病患者左心房和颈动脉功能明显发生损害,其中合并H型高血压的患者功能损害更加明显,且与颈动脉硬化及左心房功能损害具有相关性,提示H型高血压能加剧糖尿病肾病患者左心房及颈动脉功能损害。
文摘This article reports the various methods used to assess diaphragmatic function by ultrasonography.The excursions of the two hemidiaphragms can be measured using two-dimensional or M-mode ultrasonography,during respiratory maneuvers such as quiet breathing,voluntary sniffing and deep inspiration.On the zone of apposition to the rib cage for both hemidiaphragms,it is possible to measure the thickness on expiration and during deep breathing to assess the percentage of thickening during inspiration.These two approaches make it possible to assess the quality of the diaphragmatic function and the diagnosis of diaphragmatic paralysis or dysfunction.These methods are particularly useful in circumstances where there is a high risk of phrenic nerve injury or in diseases affecting the contractility or the motion of the diaphragm such as neuro-muscular diseases.Recent methods such as speckle tracking imaging and ultrasound shear wave elastography should provide more detailed information for better assessment of diaphragmatic function.
