左室壁内缩短分数评价收缩功能及其与舒张功能相关性的研究

目的:探讨左室壁内缩短分数(mFS )评价高血压患者收缩功能及其与左室舒张功能的关系.方法:收集高血压组51例,正常对照组47例.分析临床特点,行超声心动图检查.收缩功能测定左室室壁厚度,左室内径,左室容量,测定射血分数(EF),缩短分数(FS)以及左室mFS.心脏舒张功能,取二尖瓣血流频谱,记录二尖瓣舒张期血流频谱,记录舒张早期(E)和舒张晚期(A)血流速度峰值.采用组织速度多普勒成像技术测定二尖瓣环室间隔侧和侧壁侧的舒张早期心肌运动速度(Em)和舒张晚期心肌运动速度(Am),取平均值.探讨左室收缩功能和舒张功能的相关性.结果:①收缩功能:高血压组与正常对照组比较:左室舒张末间隔厚度明显增加[(1.18±0.28):(0.95±0.13),P<0.001]、左室舒张末后壁厚度明显增加[(1.01± 0.17):(0.89±0.17),P<0.01]、左室mFS明显降低[( 18.0± 4.9) vs (22.3±5.9), P<0.01],而2组间左室EF和FS差异无统计学意义.②舒张功能:高血压组与对照组比较,二尖瓣血流频谱差异无统计学意义;组织多普勒成像显示,二尖瓣环Em明显降低[(8.22± 2.23):(9.91±2.52),P<0.05],二尖瓣环Em/Am明显降低[(0.72± 0.23):(0.98±0.26),P<0.01]、二尖瓣E/Em明显增加[(9.38±3.19):(7.45±2.10), P<0.01].③mFS与Em/Am显著正相关(r=0.55,P<0.001 )、与E/Em显著负相关(r=-0.38,P<0.05).左室EF和FS与上述指标无相关性.结论:左室mFS是评价高血压患者收缩功能的有力指标,与早期舒张功能受损有关.

The relationship between diastolic function and systolic function assessed by left ventricular mid-wall fractional shortening

Objective:To investigate the association between diastolic function and systolic function assessed by mid-wall fractional shortening(mFS) in patients with hypertension. Method:There were 51 cases of hypertension and 47 cases of healthy volunteers enrolled in the study. Systolic cardiac function parameters were measured as ejection fraction(EF) , fractional shortening(FS) and mFS. Diastolic parameteres included peak early diastolic velocity (E) and late diastolic velocity (A) of mitral flow and their ratio (E/A), peak early diastolic velocity (Em) and late diastolic velocity (Am) of mitral annulus and their ratio (Em/Am). The correlation among these parameters was analyzed. Result:Left ventricular walls were thicker and mFS were lower in patient with hypertesion than those in control. The TDI parameters of left ventricular diastolic function such as Em and Em/Am were lower and E/Em was higher in hypertension group than in control. There were a positive correlation between mFS and Em/Am (r＝0.55,P<0.001). There was a negative correlation between mFS and E/Em(r=-0.38 P<0.01). Conclusion:mFS is a valuable parameter to assess systolic function in early stage of hypertension, which is associated with early stage of diastolic function damage.