二维斑点追踪技术评价慢性阻塞性肺疾病患者右心室收缩功能

目的 探讨二维斑点追踪成像(2D-STI)技术评价慢性阻塞性肺疾病(COPD)患者右心室收缩功能的临床价值。方法 将58例COPD患者按肺动脉收缩压分为轻度肺动脉高压(MPAH)组和无肺动脉高压(NPAH)组,另选取30名健康志愿者为正常对照组。应用二维应变软件于剑下四腔心切面测量右心室游离壁基底段和中间段的纵向收缩期峰值速度(Vs)、收缩期峰值应变(S)及收缩期峰值应变率(SRs)。对比各组间常规超声参数及二维应变参数的差异。结果 常规超声参数:与正常对照组比较,MPAH组及NPAH组右心室前壁厚度(RVAW)和舒张末期右心室中间段内径均明显增大,MPAH组收缩末期主肺动脉内径(MPA)增大(P均<0.05);与NPAH组比较,MPAH组RVAW和MPA均明显增大(P均<0.05)。二维应变参数:与正常对照组比较,MPAH组和NPAH组右心室游离壁基底段及中间段Vs、S、SRs均显著减低(P均<0.05);与NPAH组比较,MPAH组右心室游离壁基底段及中间段S及Vs均显著减低(P均<0.05)。结论 2D-STI技术是一种早期、客观评价COPD患者右心室收缩功能的新方法。

Two-dimensional speckle tracking imaging technology assessment of right ventricular systolic function in patients with chronic obstructive pulmonary disease

Objective To explore the clinical significance of two-dimensional speckle tracking imaging (2D-STI) in assessing the right ventricular systolic function in patients with chronic obstructive pulmonary disease (COPD). Methods Totally 58 patients with COPD and 30 healthy volunteers (control group) were enrolled. The patients with COPD were divided into mild-pulmonary arterial hypertension (MPAH) group and non-pulmonary arterial hypertension (NPAH) group based on pulmonary artery systolic pressure. Longitudinal peak systolic velocity (Vs), strain(S) and strain rate (SRs) were measured in right ventricular free wall of basal and mid segment by 2D-STI from the subcostal view. The differences of conventional ultrasound parameters and two-dimensional strain parameters were compared among three groups. Results Conventional echocardiography parameters: Compared with control group, right ventricular anterior wall end-diastolic thickness (RVAW) and right ventricular end-diastolic diameter at the mid level significantly increased in MPAH group and NPAH group, MPA significantly increased in MPAH group (all P<0.05). Compared with NPAH group, RVAW and main pulmonary artery end-systolic diameter (MPA) significantly increased in MPAH group (both P<0.05). Two-Dimensional strain parameters: Compared with the control group, Vs, S, and SRs of mid and basal segment in MPAH and NPAH group significantly decreased (all P<0.05). Compared with NPAH group, Vs and S of mid and basal segment significantly decreased in MPAH group (both P<0.05). Conclusion 2D-STI is an early, objective and new promising method for evaluation of right ventricular systolic function in patients with COPD.