斑点追踪成像评价高血压患者左心室重构对舒张功能的影响

目的探讨二维斑点追踪成像技术评估高血压患者左心室重构对其心脏舒张功能的影响。方法选取原发性高血压患者90例，其中正常构型患者30例、向心性重构患者30例、向心性肥厚患者30例，另选取身高、体重与年龄相匹配的健康对照组30例。应用二维斑点追踪成像技术在左心室短轴心尖水平测量心尖部峰值旋转角度及其达峰时间，并左心室短轴心底水平测量心底部峰值旋转角度及其达峰时间，从而计算出左心室峰值扭转角度。结果正常构型组左心室峰值扭转角度较向心性重构组和向心性肥厚组增大（P〈0．05），而向心性肥厚组左心室峰值扭转角度较正常构型组和向心性重构组减小（P〈0．05）。结论正常构型患者左心室扭转运动明显增强，向心性肥厚患者左心室扭转运动减小。随着左心室舒张功能的减低，左心室扭转运动逐渐减低。二雏斑点追踪成像为高血压患者左心室重构对舒张功能的影响提供了一个量化的指标。

Diastolic Function Evaluation in Hypertension with Left Ventricular Remodelling Using Speckle Tracking Imaging

Objective To evaluate diastolic function of left ventricular remodelling by speckle tracking imaging. Methods Ninety patients with primary hypertension, including thirty cases of normal remodelling pattern, thirty cases of concentric remodelling pattern and thirty cases of concentric hypertrophy pattern were enrolled, and thirty healthy vol- unteers were in control group. Peak basal rotation, peak apical rotation at basal and apical short-axis views were mea- sured with speckle tracking imaging, and peak left ventricular torsion was calculated. Results Peak left ventricular tor- sion was significantly increased in normal remodelling group than that in other groups, and it was decreased in concentric hypertrophy group compared with other groups（P〈0.05）. Conclusion Systolic torsion is significantly increased in pa- tients with normal remodelling pattern, and declined in patients with concentric hypertrophy pattern. Systolic torsion is gradually declined with the decrease of left ventricular diastolic function. Speckle tracking imaging may provide a new in- dex for evaluation of the left ventricular remodelling of hypertension patients with diastolic function.