应变率成像对不同左室构型高血压患者左房收缩功能的研究

目的探讨应变率成像评价不同左室构型的原发性高血压患者左房收缩功能的价值。方法获取25例正常人和45例高血压患者（包括左室构型正常组25例和左室肥厚组20例）四腔观、三腔观和二腔观应变率显像,测量左房前壁、下壁、后壁、侧壁和房间隔的心房收缩期左房应变率（SRa）,采用M-型、二维超声和多普勒技术测量高血压患者左室几何构型,测量二尖瓣频谱A峰流速（VA）、A峰速度时间积分（A-VTI）、左房射血力（AEF）及左房缩短分数（LAFS）。结果高血压各组LAFS、AEF及左房SRa均高于正常组,而A、E/A和A-VTI仅在正常组与左室肥厚组间有显著性差异,在正常组与左室构型正常组间无显著性差异;左房SRa与LAFS及AEF相关性良好（相关系数分别为0.83和0.78,P〈0.05）。结论应变率成像能早期准确、无创评价原发性高血压左房收缩功能。

Study on Left Atrial Systolic Function in Patients with Essential Hypertension with Different Patterns of Left Ventricular Geometric Models Using Strain Rate Imaging

Objective To explore left atrial(LA)systolic function in patients with essential hypertension patients with different patterns of left ventricular(LV)geometric models using strain rate imaging.Methods Strain rate imaging were performed on 45 patients with essential hypertension at two-chamber,three-chamber and four chamber views and the left atrial strain rate at each left atrial middle segment(anterior,inferior,posterior,lateral and septal)were measured during left atrial systolic phase.Peak A velocity(A),velocity time integral of A-wave(A-VTI),atrial ejection force(AEF)and left atrial fractional shortening(LAFS)were measured on M-mode,2D and pulsed wave Doppler imaging.Results Compared with the normal group,AEF,LAFS,SRa were significantly higher in two hypertension patient groups.A,E/A,A-VTI were not significantly different between the normal and the normal geometric LV groups,but significantly higher between the normal and the remodeling LV groups.In hypertension groups,SRa correlated closely with AEF(r=0.78,P<0.05)and LAFS(r=0.83,P<0.05).Conclusions Strain rate imaging can assess left atrial systolic function early,exactly and noninvasively.