应变率成像评价左心室射血分数正常的心力衰竭患者左心房功能

目的 探讨应变率成像(SRI)评价左心室射血功能正常的心力衰竭(HF-NSF)患者左心房功能的价值.方法 对94例心力衰竭患者(LVEF正常组28例、LVEF减低组66例)和36例体检健康者(对照组)行心脏超声检查,获取左心房收缩前容积(Vpre)、左心房最小容积(Vmin)、左心房最大容积(Vmax)、左心房每搏量(LASV)、左心房主动排空分数(LAAEF)、左心房被动排空分数(LAPEF)、左心房射血力(LAEF);在SRI模式下测量心室收缩期应变率(SSr)、心室舒张早期应变率(ESr)、心房收缩期应变率(ASr).结果 Vpre、Vmin、Vmax及LAPEF对照组与LVEF正常组比较差异无统计学意义(P>0.05);LASV、LAAEF及LAEF在两组间比较(18.38±3.07)ml vs(20.68±2.69)ml、(0.39±0.08)%vs(0.46±0.08)%、(44.32±5.92)%vs(46.83±4.20)%,差异有统计学意义(P<0.05);LVEF正常组ASr、SSr高于对照组(2.52±0.44)s-1 vs(2.15±0.42)s-1、(3.05±0.47)s-1 vs(2.74±0.42)s-1(P<0.05);ESr呈递减趋势(2.44±0.56)s-1vs(2.73±0.51)s-1(P<0.05).相关分析显示ASr与LAEF呈显著正相关.结论 SRI可敏感地量化评价HF-NEF患者左心房功能.

Evaluation of left atrial function by strain rate imaging in patients with heart failure in normal left ventricular ejection fraction

Objective To evaluate the left atrial function by strain rate imaging in patients with heart failure in normal left ventricular ejection fraction（HF-NEF）.Methods Twenty-eight HF-NSF patients were enrolled into this study with thirty-six healthy volunteers as controls.Standard two-dimensional and Doppler echocardiography were performed as well as Doppler tissue imaging.The following atrial parameters were acquired at baseline：maximal left atrial volume（Vmax）,minimal left atrial volume（Vmin）,just before the ＂p＂ wave on ECG（Vpre）,left atrial ejection force（LAEF）,left atrial stroke volume（LASV）,left atrial active emptying fraction（LAAEF） and passive emptying fraction（LAPEF）.Systolic（SSr）,early diastolic（ESr）,late diastolic（ASr） strain rate were calculated off line by software.Results Vpre,Vmin,Vmax and LAPEF were not significantly different between HF-NEF cohorts and normal subjects（all P〈0.05）.Compared to normal subjects,LASV,LAAEF and LAEF were displaced upwards in HF-NEF cohorts（20.68±2.69） ml vs（18.38±3.07） ml,（0.46±0.08）% vs（0.39±0.08）%,（46.83±4.20）% vs（44.32±5.92）%（all P〈0.05）.ASr and SSr were significantly greater,and ESr was significantly lower in HF-NEF cohorts than normal subjects（2.52±0.44） s^-1 vs（2.15±0.42） s^-1,（3.05±0.47） s^-1 vs（2.74±0.42） s^-1,（2.44±0.56） s^-1 vs（2.73±0.51） s^-1（all P〈0.05）.Multiple linear regression analysis demonstrated that ASr was significantly related to LAEF.Conclusion Strain rate imaging can sensitively and quantitatively provide information for assessing left atrial function in HF-NEF patients.