摘要
目的:应用超声分层应变技术评价二尖瓣脱垂伴中-重度反流患者左心室心肌收缩功能。方法:收集2021年9月—2022年12月于宜昌市中心人民医院确诊的二尖瓣脱垂伴中-重度反流患者作为研究组(n=30),纳入同期健康体检者作为对照组(n=30)。分析两组患者超声应变参数,包括整体纵向应变(GLS)、峰值收缩离散度(PSD)、左心室心内膜下心肌GLS(GLSendo)、左心室中层心肌GLS(GLSmid)、左心室心外膜下心肌GLS(GLSepi)及各层心肌纵向应变值(LS)等,计算心肌跨壁应变梯度(ΔGLS),比较两组各参数的差异及各参数间的相关性。采用ROC曲线分析左心室分层应变参数评估二尖瓣脱垂伴中-重度反流患者左心室收缩功能的效能。结果:研究组患者的收缩压、左心房收缩末期内径(LAD)、左心室舒张末期内径(LVDd)及每搏量(SV)均明显高于对照组(均P<0.05)。研究组患者的|GLS|、|GLSendo|、|GLSmid|、|GLSepi|、ΔGLS及各节段|LS|均显著减低(均P<0.05)。相关性分析结果显示,研究组患者LAD、LVDd与GLS、GLSendo、GLSmid及GLSepi呈负相关。ROC曲线显示,超声分层应变参数中,GLSendo(AUC=0.869)、GLSmid(AUC=0.801)、GLSepi(AUC=0.781)评价二尖瓣脱垂伴中-重度反流患者左心室收缩功能具有较高诊断效能(均P<0.05)。结论:超声分层应变技术可评估二尖瓣脱垂伴中-重度反流患者左心室及各层心肌受累程度,反映左心室收缩功能变化。
Objective:To evaluate left ventricular systolic function in patients with mitral valve prolapse with moderate to severe regurgitation by stratified ultrasonic strain technique.Methods:Patients with mitral valve prolapse with moderate to severe regurgitation treated in Yichang Central People's Hospital from September 2021 to December 2022 were collected as the study group(n=30),and healthy subjects were included as the control group(n=30).Ultrasonic strain parameters of the two groups were analyzed,including global longitudinal strain(GLS),peak systolic dispersion(PSD),left ventricular subendocardial myocardium GLS(GLSendo),left ventricular median myocardium GLS(GLSmid),left ventricular subepicardial myocardium GLS(GLSepi)and longitudinal strain values of each myocardium(LS),etc.The myocardial transmural strain gradient(ΔGLS)was calculated,and the difference of parameters and the correlation of parameters between the two groups were compared.ROC curve was used to analyze the efficacy of left ventricular stratified strain parameters in evaluating left ventricular systolic function in mitral valve prolapse with moderate to severe regurgitation.Results:Systolic blood pressure,left atrial end-systolic diameter(LAD),left ventricular end-diastolic diameter(LVDd)and stroke volume(SV)in study group were significantly higher than those in control group(all P<0.05).|GLS|,|GLSendo|,|GLSmid|,|GLSepi|,ΔGLS and|LS|of each segment in the study group were significantly reduced(all P<0.05).Correlation analysis showed that LAD and LVDd were negatively correlated with GLS,GLSendo,GLSmid and GLSepi.ROC curve showed that GLSendo(AUC=0.869),GLSmid(AUC=0.801)and GLSepi(AUC=0.781)had high diagnostic efficiency in evaluating left ventricular systolic function in patients with mitral valve prolapse with moderate to severe regurgitation(all P<0.05).Conclusion:Stratified ultrasound strain technique can evaluate the involvement degree of left ventricular and myocardium in mitral valve prolapse with moderate to severe regurgitation,and refle
作者
涂一凡
刘蓉
周军
曾华容
董芝芝
陈悦
石豆子
Tu Yifan;Liu Rong;Zhou Jun;Zeng Huarong;Dong Zhizhi;Chen Yue;Shi Douzi(Department of Ultrasound,Yichang Central People's Hospital,The First College of Clinical Medical Science,China Three Gorges University&Hubei Key Laboratory of Ischemic Cardiovascular Disease,Yichang 443003,China)
出处
《巴楚医学》
2024年第1期86-91,共6页
Bachu Medical Journal
基金
湖北省卫生健康委面上项目(No:WJ2017M225)。
关键词
二尖瓣脱垂伴中-重度反流
超声分层应变技术
左心室收缩功能
心肌收缩
mitral valve prolapse with moderate to severe regurgitation
ultrasonic layered strain technique
left ventricular systolic function
myocardial contraction
