三维斑点追踪技术评价类风湿关节炎患者左心室收缩功能

目的 应用三维斑点追踪技术（3D-STI）评价类风湿关节炎（RA）患者左心室收缩功能。方法 对40例RA患者（RA组）、40名健康体检者（对照组）行常规超声心动图检查，测量参数左心室舒张末期内径（LVDd）、左心室收缩末期内径 （LVDs）、室间隔舒张末期厚度（IVSd）、左心室后壁舒张末期厚度（LVPWd）、二尖瓣口舒张期E峰、A峰、E/A值、左心室舒张末期容积（EDV）、左心室收缩末期容积（ESV）、左心室射血分数（LVEF）；同时采集3D-STI图像，并应用4D Auto LVQ软件分析计算出左心室收缩期整体纵向应变（LVGLS）、左心室收缩期整体径向应变（LVGRS）、左心室收缩期整体圆周应变（LVGCS）、左心室收缩期整体面积应变（LVGAS），比较RA组与对照组常规超声心动图及3D-STI参数的差异。结果 RA组与对照组LVDd、LVDs、 IVSd、LVPWd、E峰、A峰、E/A值、EDV、ESV、LVEF的差异均无统计学意义（P均>0.05）。两组间LVGLS、LVGRS、LVGCS、LVGAS差异均有统计学意义（P均<0.05）。结论 3D-STI技术可较常规超声心动图更早地检测出RA患者左心室收缩功能的改变。

Application of three-dimensional speckle tracking echocardiography in assessing left ventricular systolic function in rheumatoid arthritis patients

Objective To assess the left ventricular systolic function of rheumatoid arthritis (RA) patients by 3-dimensional ultrasound speckle tracking imaging (3D-STI). Methods Totally 40 RA patients (RA group) and 40 healthy volunteers (control group) were enrolled in the study. All the participants underwent conventional echocardiography,and conventional parameters of left ventricular end-diastolic diameter (LVDd), left ventricular end-systolic diameter (LVDs), interventricular septal depth(IVSd), left ventricular posterior wall depth (LVPWd), early diastolic mitral inflow velocities (E), late diastolic mitral inflow velocities (A), E/A ratio, end-diastolic volume (EDV), end-systolic volume (ESV) and left ventricular ejection fraction (LVEF) were acquired. 3D-STI examinations were performed and left ventricular systolic global strain parameters of left ventricular global longitudinal strain (LVGLS), left ventricular global radial strain (LVGRS), left ventricular global circumferential strain (LVGCS) and left ventricular global area strain (LVGAS) were analyzed by 4D Auto LVQ software. All those parameters between the two groups were compared. Results There were no statistic differences in LVDd, LVDs, IVSd, LVPWd, E, A, E/A ratio, EDV, ESV and LVEF between the two groups (all P>0.05). LVGLS, LVGRS, LVGCS and LVGAS were lower in RA group than those in the control group, and the differences were statistically significant (all P<0.05). Conclusion 3D-STI can demonstrate the changes of left ventricular function earlier than conventional echocardiography in RA patients.