三维斑点追踪成像技术定量评价亚临床甲状腺功能亢进患者左心室收缩功能

目的 探讨三维斑点追踪成像（3D-STI）技术定量评价亚临床甲状腺功能亢进（SH）患者左心室收缩功能的价值。方法 对33例未经治疗SH患者（SH组）及性别、年龄相匹配的35名健康志愿者（对照组）进行实验室检查、常规超声及3D-STI检查，获取实验室指标促甲状腺激素（TSH）、三碘甲状腺原氨酸（T₃）、甲状腺素（T₄）、游离甲状腺素（FT₄），左心室常规指标左心房内径（LAD）、室间隔厚度（IVST）、左心室舒张末期内径（LVEDD）、左心室收缩末期内径（LVEDS）、左心室射血分数（LVEF）及左心室整体和17节段纵向、径向和面积峰值应变，比较2组差异。结果 SH组与对照组间TSH、T₄和FT₄差异均有统计学意义（P均<0.05），LAD、IVST、LVEDD、LVEDS、LVEF差异均无统计学意义（P均>0.05）。SH组与对照组间左心室中间段下侧壁、心尖段下壁的面积峰值应变，心尖段下壁及心尖帽的径向峰值应变差异均无统计学意义（P均>0.05），SH组心脏整体及其余各节段各峰值应变均较对照组降低（P均<0.05）。SH患者左心室整体面积峰值应变与TSH呈正相关（r=0.82，P<0.01），与FT₄呈负相关（r=-0.67，P<0.01）。结论 3D-STI技术可早期定量评价SH患者左心室整体及局部收缩功能；SH患者左心室各节段应变值呈弥漫性下降。

Three-dimensional speckle tracking technique in quantitative evaluation of left ventricular systolic function in patients with subclinical hyperthyroidism

Objective To investigate the value of three-dimensional speckle tracking imaging (3D-STI) in evaluation of left ventricular systolic function in patients with subclinical hyperthyroidism (SH). Methods Totally 33 untreated SH patients (SH group) and 35 healthy volunteers (control group) with matched sex and age were enrolled. All the subjects underwent laboratory examination, routine ultrasound and 3D-STI examination. The indexes including thyroid stimulating hormone (TSH), triiodothyronine (T₃), thyroxine (T₄), free thyroxine (FT₄), left atrial diameter (LAD), interventricular septal thickness (IVST), left ventricle diameter of end-diastolic (LVEDD), left ventricle diameter of end-systolic (LVEDS), left ventricular ejection fraction (LVEF), longitudinal, radial and area peak strains of the left ventricle as a whole and 17 segments were compared between the two groups. Results There were significant differences of TSH, T₄ and FT₄ between SH group and control group (all P<0.05), while no significant difference of LAD, IVST, LVEDD, LVEDS nor LVEF was detected between the 2 groups (all P>0.05). The area peak strain of left ventricular medial inferior wall and apical inferior wall, radial peak strain of apical inferior wall and apical cap had no statistically significant difference between SH group and control group (all P>0.05), while the peak strain of whole heart and other segments in SH group were lower than that in control group (all P<0.05). Left ventricular global area peak strain in SH patients positively correlated with TSH (r=0.82, P<0.01) and negatively correlated with FT₄ (r=-0.67, P<0.01). Conclusion 3D-STI can quantitatively evaluate left ventricular systolic function in SH patients at an early stage, and the strain values of left ventricular segments in these patients decrease diffusely.