应变率成像评价原发性高血压患者左心室心肌的舒缩功能障碍

目的:探讨应变率成像技术(SRI)为临床无创评估原发性高血压患者心脏舒缩功能障碍的价值。方法:将90例原发性高血压患者依据左心室心肌质量指数(LVMI)分为两组:左室肥厚(LVH)组46例和无左室肥厚(NLVH)组44例。行常规超声心动图检查并测量左房、左室大小,室间隔和左室后壁厚度,同时测定LVEF和LVFS、E/A比值等参数。应用应变率成像技术,对左心室纵向各室壁心肌在整个心动周期中SR参数进行分析测定,并与45例正常人(对照组)对照比较。结果:⑴与对照组及NLVH组相比,LVH组左房较大,室壁增厚,心肌收缩期SR参数绝对值均明显降低(P<0.05),而LVEF、LVFS无差异(P>0.05);并且室壁收缩期SR的绝对值与室壁的肥厚程度呈负相关(P<0.05)。⑵LVH组心肌快速充盈期SR参数同E/A比值都显著降低(P<0.05)。而室壁的厚度与室壁的快速充盈期SR无相关性(P>0.05)。3组心室肌的心房收缩期SR参数无明显差别(P>0.05)。⑶LVH组收缩后收缩(PSC)的出现率(59.8%)显著高于Normal组(21.0%)和NLVH组(36.6%)(P<0.05)。LVH组收缩后收缩的SR绝对值、收缩后收缩与收缩期SR的比值均大于其他两组(P<0.05)。结论:SR能反映不同程度原发性高血压患者左心室心肌舒缩功能障碍。

Assessing regional left ventricular dysfunction of systole and diastole in patients with essential hypertension by strain rate imaging

Objective:To investigate the clinical value of SR which is used in evaluating the dysfunction of both systole and diastole in hypertensive patients with no-insults. Methods:According to the left ventricular mass index (LVMI), 90 hypertensive patients were divided into two groups: 46 patients with left ventricular hypertrophy(LVH) and 44 patients who had no left ventricular hypertrophy(NLVH). Routine parameters and values of strain rate in six left ventricular walls of 90 patients and 45 normal subjects were acquired and analyzed offline respectively. Results:⑴Compared with the normal group and the NLVH group, the left atria of the patients in the LVH group was bigger and the ventricular walls were thicker. Absolute values of SR indexes in the LVH segments during the systolic phase reduced significantly (P<0.05), although there were no differences in LVEF and LVFS in the three groups(P>0.05). There were remarkably negative correlation between the thickness of the left ventricular walls and the absolute values of SR in systole (P<0.05). ⑵Same as E/A ratio, the SR indexes in the LVH segments during the rapid filling period were lower than in the other groups(P<0.05). On the whole, no significant differences were found in the SR indexes in the segments during the atrial systolic phase in the three groups(P>0.05). ⑶The incidence of postsystolic compression(PSC) in LVH segments(59.8%) was significantly higher than that in the normal(21.0%) and NLVH segments(36.6%)(P<0.05). Absolute values of SR in PSC and the ratio postsystolic compression to systole in the LVH segments were apparently larger(P<0.05).Conclusion:SR is useful in evaluating the left ventricular functioe of both systole and diastole in patierts with hypertension.