摘要
目的:应用压力-应变环(pressure strain loop,PSL)技术研究左室射血分数(left ventricular ejection fraction,LVEF)正常的多发性骨髓瘤(multiple myeloma,MM)患者早期左室做功状况。方法:前瞻性选取2021年06月至2022年07月52例在血液科确诊的MM患者和32例年龄、性别相匹配的同期健康正常人纳入研究。均进行传统超声心动图检查并进行STE分析峰值应变离散度(peak strain dispersion,PSD)及整体纵向应变(global longitudinal strain,GLS);输入血压值后软件分析出整体做功指数(global work index,GWI)、整体有效功(global constructive work,GCW)、整体无效功(global waste work,GWW)、整体做功效率(global work efficiency,GWE),对两组之间所有测量参数进行差异性、相关性的统计学分析。结果:MM组E/A比值、室间隔运动速度(IVS e’)、左室侧壁运动速度(LVSW e’)比对照组明显降低(Z/t=3.725、2.822、2.816),A值、室间隔E/e’比对照组明显增高(Z/t=2.876、5.486),差异均有统计学意义(P<0.05);MM组的GLS绝对值、GWI、GWE均比对照组降低(U=360.000、470.000、118.000),GWW、PSD比对照组增高(U=137.000、381.500),差异均有统计学意义(P<0.05)。GLS绝对值、GWI、GCW、GWE与LVEF呈正相关(r=0.716、0.522、0.503、0.335,P<0.05);GWW、PSD与LVEF呈负相关(r=-0.236、-0.543,P<0.05)。重复性检测显示操作性、重复性良好。结论:PSL技术可定量评估早期MM患者左心室做功状况及左室收缩不同步,比常规超声心动图更早地发现左室收缩功能损伤,可为临床提供参考依据。
Objective:To study the early left ventricular work in multiple myeloma patients with normal left ventricular ejection fraction(LVEF)by PSL technology.Methods:A total of 52 patients with multiple myeloma diagnosed in the department of hematology from June 2021 to July 2022 and 32 age-and gender-matched healthy controls were prospectively enrolled in the study.Conventional echocardiography was performed and STE was used to analyze peak strain dispersion(PSD)and global longitudinal strain(GLS).After inputting blood pressure,the software automatically analyzed the global work index(GWI),global constructive work(GCW),global waste work(GWW),global work efficiency(GWE).The differences and correlations of all the measured parameters were statistically analyzed between the two groups.Results:The E/A ratio,IVS e',LVSW e'in the MM group were significantly lower than those in the control group(Z/t=3.725,2.822,2.816),while A value,E/e'was significantly higher than that in the control group(Z/t=2.876,5.486),with statistical significance(P<0.05).The GLS absolute value,GWI,and GWE of the MM group were all lower than those of the control group(U=360.000,470.000,118.000),while GWW and PSD were higher than those of the control group(U=137.000,381.500),with statistical significance(P<0.05).GLS absolute value,GWI,GCW,GWE were positively correlated with LVEF(r=0.716,0.522,0.503,0.335,P<0.05).GWW and PSD were negatively correlated with LVEF( r =-0.236,-0.543, P <0.05).The repeatability test showed good operability and repeatability. Conclusion: PSL technology can quantitatively evaluate the left ventricular work and left ventricular systolic dyssynchrony in patients with early multiple myeloma,and can detect the left ventricular systolic function injury earlier than conventional echocardiography,which can provide clinical reference.
作者
刘娟
徐俊
鞠萍
孙红光
刘晨
LIU Juan;XU Jun;JU Ping;SUN Hongguang;LIU Chen(Department of Ultrasound,the Fourth People's Hospital of Lianyungang,Jiangsu Lianyungang 222023,China;Department of Ultrasound,Medical Imaging Center,Affiliated Hospital of Yangzhou University,Jiangsu Yangzhou 225001,China;Department of Cardiology,Affiliated Hospital of Yangzhou University,Jiangsu Yangzhou 225001,China)
出处
《现代肿瘤医学》
CAS
北大核心
2023年第21期4003-4007,共5页
Journal of Modern Oncology
基金
江苏省扬州市科技计划基金(编号:YZ2022079)。
