二维斑点追踪成像技术在评价高血压病患者左心室局部舒张功能中的应用

目的 应用超声斑点追踪成像技术评价高血压病患者左心室局部舒张功能.方法 对22例原发性高血压患者(观察组)和16例健康成年人(对照组)进行心脏超声检查,首先利用组织多普勒成像技术(TDI)测量二尖瓣环舒张期速度评价左心室整体舒张功能,并获取心尖四腔心、二腔心和长轴观以及胸骨短轴观,再应用STI技术,脱机分析测量舒张期纵向应变、应变率,径向应变、应变率,周向应变、应变率,以及舒张早期应变率/舒张早期应变率比值(RSe/RSa比值),评价局部心肌舒张功能.结果 观察组纵向舒张期早期速度E峰明显低于对照组(P<0.05),且从基底段至心尖段的纵向速度(E峰、A峰),存在递减趋势,观察组的舒张早期纵向应变率及周向应变率也明显低于对照组(P<0.05).结论 利用超声斑点追踪应变成像技术能够定量评价左心室局部心肌舒张早期功能,原发性高血压患者虽然左心室整体舒张功能在正常范围内,但其局部心肌已经存在舒张早期功能异常.

Application of two-dimensional speckle tracking imaging in evaluation of left ventricular diastolic function of patients with primary hypertension

Objective To evaluate the left ventricular diastolic function in patients with essential hypertension by using ultrasound speckle tracking imaging technique .Methods Twenty-two patients with primary hypertension ( observation group) and 16 healthy adults ( control group ) were enrolled in the study . All the subjects were examined by echocardiography ,firstly using tissue Doppler imaging ( TDI) technique to detect mitral ring diastolic velocity to evaluate left ventricular diastolic function ,and to obtain apical four chamber heart ,two chamber heart and long axis view and sternum short axis view,then using STI technique to measure (offline analysis) diastolic longitudinal strain and strain rate,radial strain and strain rate, perimeter strain and strain rate ,and the ratio of diastolic early strain rate /early diastolic strain rate ( RSe/RSA ratio) to evaluate local cardiac muscle diastolic function .Results The longitudinal diastolic early velocity E peak in observation group was significantly lower than that in control group ( P <0.05),moreover, the longitudinal velocity (E peak, A peak) from basal segment to cardiac apical segment showed a gradual decreasing trend , besides, the early diastolic longitudinal strain rate and perimeter strain rate were significantly lower than those in control group ( P <0.05).Conclusion The ultrasound speckle tracking strain imaging technique can quantitatively assess left ventricular regional myocardial diastolic function， for local myocardial diastolic early dysfunction exists in patients with primary hypertension already ，although patient's global left ventricular diastolic function is in the normal range.