三维应变参数评价肝硬化左心室心肌力学功能

目的应用三维应变参数评价早期肝硬化患者左心室心肌力学功能状态,探讨超声诊断肝硬化性心肌病的有效指标。方法健康对照组为28名健康志愿者,肝硬化组为25例早期肝硬化患者。应用三维斑点追踪技术(3D-STI)分析两组左心室整体三维峰值应变(G3DS)、整体纵向峰值应变(GLS)、心肌不同步指数(ASDI),常规超声测量左室射血分数(LVEF),左室舒张末期容积(LVEDV),二尖瓣口血流E/A比值。结果 B组左心室整体G3DS、GLS较A组减低(P0.05)、ASDI较A组增加(P0.05),LVEDV、LVEF较A组差异无统计学意义,B组二尖瓣口血流E/A比值较A组减低,差异有统计学意义(P0.05)。结论超声三维应变参数可有效评价早期肝硬化引起的左心室心肌收缩功能障碍。

Assessment on regional myocardial mechanics of left ventricle in patients with liver cirrhosis using three-dimensional strain parameters

Objective To evaluate myocardial mechanics of left ventricle in patients with early-stage liver cirrhosis using three-dimensional echocardiographic strain parameters, and to explore effective ultrasonic parameters for diagnosis of cirrhotic cardiomyopathy.Methods Twenty-eight healthy volunteer were enrolled as controls (group A), and 25 early-stage cirrhotic patients were enrolled in group B.Three-dimensional speckle tracking imaging (3D-STI) were applied to analyze global 3-D strain (G3DS), global longitudinal strain (GLS) and area strain dyssynchrony index (ASDI) of left ventricle.Meanwhile, left ventricular ejection fraction (LVEF),left ventricular end-diastolic volume (LVEDV) and early diastolic wave/atrial contractive wave (E/A) ratio of mitral flow were measured using conventional ultrasound.Results Compared with those in group A, G3DS, GLS and E/A ratio in group B were significantly decreased (P<0.05), while ASDI was significantly increased (P<0.05).Additionally, levels of LVEDV and LVEF in group B showed no significant difference with that in group A (P<0.05).Conclusion Three-dimensional echocardiographic strain parameters could effectively evaluate left ventricular myocardial systolic dysfunction induced by early-stage liver cirrhosis.