摘要
目的探讨超声心动图左心室压力-应变环评价心力衰竭(心衰)患者左心室心肌做功的价值。资料与方法选取2019年4月—2020年4月山西省心血管病医院31例心衰患者,选取同期健康体检者30例为对照组,用二维斑点追踪技术于左心室心尖四腔切面、两腔切面、三腔切面采集动态图像,输入血压,导入EchoPAC工作站获取左心室纵向应变达峰时间离散度(PSD)、左心室心肌整体纵向应变(GLS)、心肌整体做功指数(GWI)、整体有用功(GCW)、整体无用功(GWW)、整体做功效率(GWE)等参数,比较两组参数的差异。采用Pearson分析PSD、心肌做功参数与左心室射血分数(LVEF)的相关性。采用受试者工作特征曲线评价PSD、GLS、GWW对左心室做功的诊断效能。结果与对照组比较,心衰组左心房前后径、左心室舒张末期内径、左心室舒张末期容积、左心室收缩末期容积均较大,LVEF较低(t=7.63、12.52、11.37、14.71、−18.23,P均<0.05);GLS、GWI、GCW、GWE较低,PSD、GWW较高(t=37.30、−13.97、−14.14、−8.98、8.96、6.35,P均<0.05)。心衰组GCW、GWE、GWI、GLS与LVEF呈正相关(r=0.883、0.886、0.849、0.735,P均<0.001),PSD、GWW与LVEF呈负相关(r=−0.903、−0.751,P均<0.001)。PSD、GLS、GWW评价心肌收缩同步性的敏感度均为89%,特异度分别为81%、89%和85%。结论压力-应变环可有效评估心衰患者左心室心肌做功情况,其与LVEF具有一定的相关性;PSD、GLS、GWW对心衰患者心肌收缩不同步性有较好的诊断价值。
Purpose To explore the application value of pressure-strain loop in evaluating left ventricular myocardial work(MW) in patients with heart failure. Materials and Methods From April 2019 to April 2020, 31 patients with heart failure in Shanxi Cardiovascular hospital were enrolled as heart failure group. Thirty healthy volunteers were selected as control group at same period. Two-dimensional dynamic imagines in the standard apical two chamber, three chamber and four chamber views were selected by two-dimensional speckletracking. Using the off-line EchoPAC software, a tracing analysis were conducted and the blood pressure was entered to abating peak strain dispersion(PSD), global longitudinal strain(GLS), global MW index(GWI), global constructive work(GCW), global wasted work(GWW)and MW efficiency(GWE). The difference of parameters was compared between each groups. Pearson correlation was used to analyze the correlation between MW parameters and left ventricular ejection fraction(LVEF). ROC curve was used to analyze the diagnostic efficiency of PSD, GLS and GWW for left ventricular MW respectively. Results Compared with the control group, the left atrial dimension, left ventricular end-diastolic dimension, left ventricular end-diastolic volume and left ventricular end-systolic volume in heart failure group increased, while left ventricular ejection fraction decreased significantly(t=7.63, 12.52, 11.37, 14.71,-18.23, P<0.05). Compared with the control group, GLS, GWI, GCW and GWE were obviously lower, while PSD and GWW were increased in heart failure group(t=37.30,-13.97,-14.14,-8.98, 8.96, 6.35, P<0.05). In heart failure group, the positive correlations between GCW, GWE, GWI, GLS and LVEF were discovered(r=0.883, 0.866, 0.849, 0.735, P<0.001). While PSD and GWW were negatively correlated with LVEF(r=-0.903,-0.751,P<0.001). The sensitivity and specificity of PSD were 89% and 81%, of GLS were both 89%, of GWW were 89% and 85%. Conclusion Pressure-strain loop can effectively evaluate the left ventricular MW in heart fa
作者
司雪霏
李天亮
胡新玲
张晓丽
SI Xuefei;LI Tianliang;HU Xinling;ZHANG Xiaoli(Department of Ultrasound,Shanxi Cardiovascular Hospital,Taiyuan 030024,China)
出处
《中国医学影像学杂志》
CSCD
北大核心
2022年第10期1008-1012,共5页
Chinese Journal of Medical Imaging
