摘要
目的:探讨实时三维超声心动图自动定量技术在评价肥厚型心肌病(HCM)患者左心房容积及功能中的应用价值。方法:连续性收集2019年12月到2020年12月于我院确诊的HCM患者70例(HCM组),同时选取同期年龄及性别匹配的健康成年人50例(对照组)。对两组进行二维及实时三维超声心动图检查,评价两组患者传统舒张功能指标与三维左心房功能参数的差异,并进行相关性分析。结果:两组年龄、性别、体表面积、心率、血压差异均无统计学意义(P均>0.05)。HCM组患者室间隔厚度、左心室后壁厚度、最大室壁厚度、左心室射血分数、舒张早期二尖瓣血流速度峰值与二尖瓣环舒张早期速度峰值之比(E/e’)、左心室整体纵向应变(GLS)及达峰时间离散度均大于对照组,左心室舒张末期及收缩末期容积指数、间隔侧及侧壁侧二尖瓣环舒张早期运动速度峰值较对照组小,差异均有统计学意义(P均<0.05)。左心房功能参数中,HCM组三维超声心动图左心房最大容积、最小容积及收缩前容积均大于对照组,左心房被动排空分数、主动排空分数及总排空分数、储器期左心房长轴应变(LASr)及圆周应变、管道期及收缩期左心房长轴及圆周应变均小于对照组(P均<0.05)。相关性分析显示,LASr与GLS具有较强相关性(r=0.798,P<0.01)。结论:HCM患者的左心房功能明显减低,对其左心室充盈具有重要意义。实时三维超声心动图可以对不同时期左心房功能及应变进行评估,可行性及可重复性较好,具有较高的临床价值。
Objectives:To explore the application value of real-time 3D automatic echocardiography assessment technique(4D Auto LAQ)in the evaluation of left atrial(LA)volume and function in patients with hypertrophic cardiomyopathy(HCM).Methods:A total of 70 consecutive patients diagnosed with HCM in our hospital from December 2019 to December 2020 were included as the HCM group,and 50 age and sex matched healthy adults were selected as the control group.The patients were examined by two-dimensional and real-time three-dimensional echocardiography to evaluate the differences in traditional diastolic function indexes and three-dimensional left atrial function parameters between the two groups,and correlation analysis was also performed.Results:There were no significant differences in age,sex,body surface area,heart rate and blood pressure between the 2 groups(all P>0.05).The interventricular septal thickness,left ventricular posterior wall thickness,maximum chamber wall thickness,left ventricle ejection fraction,the ratio of early diastolic filling velocities to early diastolic mitral annular velocities(E/e’),global longitudinal strain(GLS),peak strain dispersion were significantly higher in HCM group than in control group,while the left ventricular end-diastolic volume index,left ventricular end-systolic volume index,ventricle septal E’,lateral wall E’were significantly lower than in control group(all P<0.05).In terms of left atrial function parameters,threedimensional maximum LA volume,minimum LA volume,LA volume at the P-wave onset were significantly higher in the HCM group than in the control group,and LA total emptying fraction,LA conduit emptying fraction,LA contractile emptying fraction,LA total strain rate,LA conduit strain,LA contractile strain,LA total strain rate(LASr),LA conduit strain rate,and LA contractile strain rate were significantly lower in the HCM group than in the control group(all P<0.05).Correlation analysis showed that LASr was positively correlated with GLS(r=0.798,P<0.01).Conclusions:Left atr
作者
李慕子
李慧
孟红
李维君
徐路杨
杨善日
王浩
王江涛
段福建
LI Muzi;LI Hui;MENG Hong;LI Weijun;XU Luyang;YANG Shanri;WANG Hao;WANG Jiangtao;DUAN Fujian(Ultrasound Imaging Center,National Center for Cardiovascular Diseases and Fuwai Hospital,CAMS and PUMC,Beijing(100037),China)
出处
《中国循环杂志》
CSCD
北大核心
2022年第5期487-493,共7页
Chinese Circulation Journal
基金
云南省心血管病临床医学中心项目(FZX2019-06-01)
中央高校基本科研业务费(3332020018)。
关键词
超声心动图描记术
三维
斑点追踪成像
肥厚型心肌病
心房功能
echocardiography
three-dimensional
speckle tracking imaging
hypertrophic cardiomyopathy
atrial function
