应用二维整体收缩期应变评价左室收缩功能

目的应用超声二维斑点追踪技术评价二维整体收缩期峰值应变在判断左室收缩功能中的价值。方法心功能不全患者52例和健康对照者30例,应用二维斑点追踪技术分别测量左室各节段收缩期纵向峰值应变、径向峰值应变和圆周峰值应变,并分别取其平均值做为左室收缩期整体纵向应变(GLS)、整体径向应变(GRS)和整体圆周应变(GCS),同时应用Simpson双面法计算左室射血分数(LVEF)。对各指标绘制受试者工作特性曲线(ROC)并获得界值。结果心功能不全患者GLS、GRS和GCS均显著低于正常对照组(P0.05);ROC评价显示GLS、GCS的曲线偏左上角,其曲线下面积分别为0.950、0.939,对应的界值分别为-13.12%、-13.86%,其诊断心功能不全的灵敏度和特异度分别为90.0%/94.4%,93.3%/83.3%,GRS的曲线下面积0.170.5,诊断左室收缩功能不全意义不显著。结论二维整体收缩期应变可较好地评价左室的收缩功能,其中GLS和GCS具有较高的诊断心功能不全的价值。

Evaluation of left ventricular systolic function by two-dimensional global systolic strain

Objective To assess the value of global systolic strain in the evaluation of left ventricular systolic function by two-dimensional speckle tracking imaging. Methods Two-dimensional echocardiography was performed in 52 patients with heart failure and 30 healthy control subjects. The systolic longitudinal strain （LS）,radial strain （RS） and circumferential strain （CS） were measured in 18 segments of left ventricular using 2D strain software. The global longitudinal strain （GLS）,global radial strain （GRS） and global circumference strain （GCS） were calculated as the average of left ventricular 18 segmental LS,RS and CS values respectively. Left ventricular ejection fraction （LVEF） was also measured by the conventional two-dimensional echocardiography. Receiver operation characteristic curves （ROC） were obtained for GLS,GCS and GRS respectively to the cut-off values.Results The values of GLS,GRS and GCS in heart failure group were significantly decreased compared with those in control group （P0.05）. ROC curves showed that the areas under the GLS and GCS curves were 0.950 and 0.939,respectively. The corresponding GLS and GCS cut-off values were -13.12% and -13.86%. The sensitivity and specificity of GLS and GCS for diagnosis of heart dysfunction were 90.0%/94.4% and 93.3%/83.3% respectively. The area under GRS curve was just 0.17 （ 0.5）,which had little diagnosis value in evaluating left ventricular systolic dysfunction.Conclusion Two-dimensional global systolic strain may help to evaluate left ventricular systolic function,in which,GLS and GCS have a significant value of diagnosis in heart dysfunction.