摘要
目的 通过二维斑点追踪成像(2D-STI)评估左心室正常构型的原发性高血压(EH)患者左心房功能并分析其应变值与左心室舒张功能障碍(LVDD)阳性指标数量间的关系。方法 选择2019年1月至2020年7月就诊于山西医科大学第一医院左心室正常构型的EH患者100例,并选择120名健康者纳入对照组。测量EH组和对照组左心房收缩末期内径(LAD)、左心室舒张末期内径(LVEDD),舒张末期室间隔厚度(IVST)、左心室后壁厚度(LVPWT)、左心室舒张早期峰值流速(E)和舒张晚期峰值流速(A)、E峰减速时间(DT)、左心室等容舒张时间(IVRT)、二尖瓣环侧壁e’(e’)和间壁e’、三尖瓣反流峰值速度(TRV)、左心室射血分数(LVEF),计算相对室壁厚度(RWT)、E/A、平均E/e’(E/e’)、左心房容积指数(LAVI)、左心室质量指数(LVMI)。依据2016年美国超声心动图学会(ASE)/欧洲心血管影像协会(EACVI)指南中左心室舒张功能评价指标--间隔e’<7 cm/s,侧壁e’<10 cm/s,平均E/e’>14,LAVI>34 mL/m^(2),TRV>2.8 m/s,将100例EH患者分为舒张功能正常、舒张功能不确定、舒张功能障碍,并将舒张功能正常和舒张功能不确定者分为0个、1个及2个LVDD指标阳性组。采用2D-STI获取对照组和EH组左心房纵向应变曲线,包括左心房储备期应变(LASs)、左心房管道期应变(LASe)、左心房房缩期应变(LASa)。分析对比EH组与对照组的基本资料、常规超声参数以及左心房应变值指标的差异,并分析LASs、LASe、LASa与LVDD阳性指标数量之间的关系。结果 EH组患者收缩压、舒张压、平均E/e’、LAVI、LAD较对照组高,室间隔e’、左心室侧壁e’、LASs、LASe较对照组低(均P<0.05)。EH组LASs(r=-0.512)、LASe(r=-0.378)与平均E/e’呈负相关(均P<0.05)。有序多分类logistic回归分析发现,LVDD发生前舒张功能不确定阶段,LASs、LASe与LVDD阳性指标数独立相关(B值分别为-0.23、-0.36,均P<0.05)。与0个阳性指标组相�
Objective To evaluate the left atrial strain in essential hypertension(EH) patients with normal left ventricular configuration by two-dimensional speckle tracking imaging(2 D-STI) and to analyze the relationship between the left atrial strain and the number of positive indicators of left ventricular diastolic dysfunction(LVDD). MethodsA total of 100 EH patients with normal left ventricular configuration admitted to the First Hospital of Shanxi Medical University from January 2019 to July 2020 were selected, and 120 healthy patients were selected as the control group. Left atrial end systolic diameter(LAD), left ventricular end diastolic diameter(LVEDD), interventricular septal thickness(IVST), left ventricular posterior wall thickness(LVPWT), early diastolic transmitral inflow veloticy(E) and late diastolic mitral valve flow velocity(A), E peak deceleration time(DT), isovolumic relaxation time(IVRT), lateral/septal mitral annular velocity(e’), maximal tricuspid regurgitation velocity(TRV), left ventricular ejection fraction(LVEF), relative ventricular wall thickness(RWT), E/A, E/e’, left atrial volume index(LAVI) and left ventricular mass index(LVMI) in EH group and control group were measured. According to 2016 American Society of Echocardiography(ASE)/European Association of Cardiovascular Imaging(EACVI) guidelines: interval e’<7 cm/s or lateral wall e’<10 cm/s, E/e’>14, LAVI>34 mL/m~2,TRV>2.8 m/s, 100 patients with EH were divided into normal diastolic function, uncertain diastolic function and diastolic dysfunction. The patients with normal diastolic function and uncertain diastolic function were divided into 0, 1, 2 LVDD index positive groups. 2 D-STI technology was used to obtain left atrial longitudinal strain curves of the two groups, including left atrial reserve strain(LASs), left atrial conduit strain(LASe) and left atrial contractile strain(LASa). The basic data, conventional ultrasonic parameters and left atrial strain values between EH group and control group were analyzed, and the relatio
作者
米娜
贾春梅
徐琨
王婧婕
胡田
樊瑞琪
MI Na;JIA Chun-mei;Xu Kun;WANG Jing-jie;HU Tian;FAN Rui-qi(Department of Ultrasound,First Hospital of Shanxi Medical University,Taiyuan,Shanxi 030001,Chin)
出处
《中华高血压杂志》
CAS
CSCD
北大核心
2022年第7期638-644,共7页
Chinese Journal of Hypertension
基金
山西省科学技术厅青年基金项目(201701D221273)
山西省卫计委青年基金项目(201601040)。
关键词
原发性高血压
左心室正常构型
左心房应变
左心室舒张功能障碍
二维斑点追踪成像技术
essential hypertension
left ventricular normal geometry
left atrial strain
left ventricular diastolic dysfunction
two dimensional speckle tracking imaging
