二维斑点追踪技术评价老年重度退行性主动脉瓣狭窄并高血压患者左心室收缩功能

目的应用二维斑点追踪技术评价老年重度退行性主动脉瓣狭窄(AS)并高血压患者左心室心肌收缩功能的改变。方法收集LVEF>54%老年重度退行性AS患者58例,按照是否合并高血压,分为AS组28例和合并高血压组30例,收集健康体检者28例为对照组,检测血压和常规超声心动图数据,包括左心室舒张末期内径、左心室后壁厚度、室间隔厚度及左心室质量指数(LVMI);二维斑点追踪技术测量左心室整体收缩期峰值纵向应变(GLS)、圆周应变(GCS)、径向应变(GRS)及扭转角度(Rot)。结果合并高血压组收缩压、舒张压、Rot明显高于对照组和AS组(P<0.01)。对照组、AS组和合并高血压组室间隔厚度、LVMI、GCS逐渐增高,GLS逐渐减低(P<0.01)。AS组和合并高血压组左心室后壁厚度明显高于对照组(P<0.01),GRS明显低于对照组[(32.2±12.2)%,(29.2±9.6)%vs (41.7±11.3)%,P<0.01]。结论与LVEF>54%的老年重度退行性AS患者比较,合并高血压的老年重度退行性AS患者左心室心肌功能进一步减低。二维斑点追踪技术是一种评价心肌早期受损的敏感方法,为临床早期诊断和治疗提供依据。

2D speckle tracking technique evaluate left ventricular contractive function in elderly severe degenerative AS patients with hypertension

Objective To evaluate the left ventricular myocardial contactive function in elderly severe degenerative AS patients with 2 Dspeckle tracking technique.Methods Fifty eight elderly degenerative AS patients with their LVEF>54% were divided into simple AS group(n=28)and AS with hypertension group(n=30)with 28 persons undergoing physical examination served as a control group.Their blood pressure,LVEDD,LVPWT,IVST and LVMI were measured.Their GLS,GCS,GRS and Rot were assayed with 2 Dspeckle tracking technique.Results The SBP,DBP and Rot were significantly higher in AS with hypertension group than in control group and simple AS group(P<0.01).The IVST,LVMI and GCS increased gradually while the GLS decreased gradually in 3 groups(P<0.01).The LVPWT was significantly thicker while the GRS was significantly lower in simple AS group and AS with hypertwension group than in control group(32.2%±12.2%,29.2%±9.6%vs 41.7%±11.3%,P<0.01).Conclusion The left ventricular myocardial contractive function is poorer in elderly severe degenerative AS patients with hypertension than in those without hypertension.2 Dspeckle tracking technique is a sensitive method for evaluating the early myocardial damage and can thus provide the diagnostic basis for its clinical treatment.