组织运动二尖瓣环位移技术评估甲状腺功能亢进症患者左心纵向收缩功能及与心肌损伤的相关性研究

目的 应用组织运动二尖瓣环位移（tissue motion mitral annular displacement，TMAD）技术评估甲状腺功能亢进症（以下简称甲亢）患者左心纵向收缩功能，并分析其与心肌损伤的相关性。方法 选取2021年7月至2022年11月右江民族医学院附属医院确诊的69例甲亢患者为研究对象，根据患者是否合并甲亢性心脏病将其分为单纯甲亢组（n=43）和甲心组（n=26），选取同期本院健康体检者35名纳入正常对照组。应用三维超声心动图获取受试者的左心室舒张末期容积（left ventricular end diastolic volume，LVEDV）、左心室收缩末期容积（left ventricular end systolic volume，LVESV）和左室射血分数（left ventricular ejection fraction，LVEF）及TMAD各参数；比较各组上述参数的差异，并分析TMAD参数与肌酸激酶同工酶（creatine kinase isoenzymes，CK-MB）、超敏心肌肌钙蛋白T（high-sensitivity cardiac troponin T，hs-cTnT）的相关性。结果 三组研究对象的LVEDV、LVESV、LVEF、TMAD各参数、CK-MB、hs-cTnT比较差异均有统计学意义（P<0.001），且LVEDV、LVESV、CK-MB和hs-cTnT正常对照组<单纯甲亢组<甲心组，LVEF及TMAD各参数正常对照组>单纯甲亢组>甲心组。TMAD各参数均与LVEF呈正相关（P<0.001），TMAD部分参数与CK-MB呈负相关（P<0.05）。结论 TMAD技术可早期评估甲亢患者左心纵向收缩功能，且与CK-MB、hs-cTnT相关。

Assessment of left ventricular longitudinal systolic function and its correlation with myocardial damage in patients with hyperthyroidism using tissue motion mitral annulus displacement technique

Objective The tissue motion mitral annular displacement (TMAD) technique was used to evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism, and its correlation with myocardial damage was analyzed. Methods Sixty-nine cases of hyperthyroidism diagnosed in Affiliated Hospital of Youjiang Medical University for Nationalities from July 2021 to November 2022 were selected as the study objects. According to whether the patients were combined with hyperthyroidism heart disease, they were divided into simple hyperthyroidism group (n=43) and thyrotoxic heart group (n=26). 35 healthy people who underwent physical examination in our hospital during the same period were selected as normal control group. Three-dimensional echocardiography was used to obtain the left ventricular end diastolic volume (LVEDV), left ventricular end systolic volume (LVESV), left ventricular ejection fraction (LVEF) and TMAD parameters. The differences of above parameters among all groups were compared, and the correlations of TMAD parameters with creatine kinase isoenzymes (CK-MB) and high-sensitivity cardiac troponin T (hs-cTnT) were analyzed. Results The LVEDV, LVESV, LVEF, TMAD parameters, CK-MB and hs-cTnT of three groups were statistically significant (P<0.001), and LVEDV, LVESV, CK-MB and hs-cTnT of normal control group < simple hyperthyroidism group < thyrotoxic heart group, LVEF and TMAD parameters of normal control group > simple hyperthyroidism group > thyrotoxic heart group. All parameters of TMAD were positively correlated with LVEF (P<0.001), and some parameters of TMAD were negatively correlated with CK-MB (P<0.05). Conclusion TMAD technology can early evaluate left ventricular longitudinal systolic function in patients with hyperthyroidism, and is related to CK-MB and hs-cTnT.