三维斑点追踪超声心动图技术与不同程度主动脉瓣狭窄患者左室功能及危险分层的关系

目的:研究三维斑点追踪超声心动图(3D-STE)技术与不同程度主动脉瓣狭窄患者左室功能及危险分层的关系。方法:选取在医院治疗的74例主动脉瓣狭窄患者纳入观察组,另选取74名健康体检者纳入健康对照组。观察两组以及不同严重程度患者的超声检查结果之间的差异,分析超声指标与疾病严重程度之间的相关性。结果:观察组患者的左心房内径(LAD)、左心室舒张末期内径(LVEDD)、舒张末期室间隔厚度(IVST)、舒张末期左心室后壁厚度(LVPWT)、整体径向应变(GRS)、总体纵向应变(GLS)、3D应变率和环向应变率分别低于健康对照组,左心室射血分数(LVEF)、旋转、扭曲和扭矩分别高于对照组。随着患者的病情加重,观察组LAD、LVEDD、IVST、LVPWT、GRS、GLS、3D应变率和环向应变率显著下降,LVEF、旋转、扭曲和扭矩显著升高。观察组患者的主动脉瓣狭窄情况与LAD、LVEDD、IVST、LVPWT、GRS、GLS、3D应变率和环向应变率呈现负相关,差异有统计学意义(r=-0.263,r=-0.251,r=-0.364,r=-0.394,r=-0.349,r=-0.397,r=-0.197,r=-0.641;P<0.05);与LVEF、旋转、扭曲及扭矩呈现正相关,差异有统计学意义(r=0.249,r=0.547,r=0.597,r=0.339;P<0.05)。结论:3D-STE技术对于患者的心肌生物力学特征以及心脏各个方向的运动指标改变具有显著的优势,对于主动脉瓣狭窄患者由于代偿功能无法完成时的心脏改变具有鉴别功能,有效提高早期疾病的鉴别能力。

The relationship between 3D-STE technique and left ventricular function,and risk stratification in patients with aortic valve stenosis of different degrees

Objective: To study the relationship between three-dimensional speckle tracking echocardiography(3D-STE) technique and left ventricular function, and risk stratification in patients with aortic valve stenosis of different degrees. Methods: 74 patients with aortic vavle stenosis who were treated in our hospital were enrolled in observation group, and 74 healthy people were enrolled in control group. The differences between two groups, and that between patients with different severity of ultrasound examination results were observed and compared, and the correlation between ultrasound indicators and disease severity were further analyzed. Results: The left atrial dimension(LAD), left ventricular end-diastolic dimension(LVEDD), interventricular septum thickness(IVST), left ventricular posterior wall thickness(LVPWT), global radial strain(GRS), Global longitudinal strain(GLS), 3D strain rate and hoop strain rate of observation group were lower than those of control group, respectively. While the left ventricular ejection fraction(LVEF), rotation, distortion and torsion of observation group were higher than those of control group. With the aggravation of the condition of patients, LAD, LVEDD, IVST, LVPWT, GRS, GLS, 3D strain rate and hoop strain rate of observation group decreased significantly, while LVEF, rotation, distortion and torsion of that increased significantly. In observation group, the stenosis of aortic valve was significantly negative correlation with LAD, LVEDD, IVST, LVPWT, GRS, GLS, 3D strain rate and hoop strain rate(r=-0.263, r=-0.251, r=-0.364, r=-0.394, r=-0.349, r=-0.397, r=-0.197, r=-0.641, P<0.05), while it was significantly positive correlation with LVEF, rotation, distortion and torsion(r=0.249, r=0.547, r=0.597, r=0.339, P<0.05). Conclusion: 3D-STE technique has significant advantages in biomechanical characteristics of myocardium and the changes of cardiac motion indicators in all directions. It has a positive identification function for the changes of heart of patients with aortic valve stenosis when compensatory function of them couldn’t be completed. It can effectively improve the identification ability for diseases at early stages.