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四维超声定量技术评价射血分数保留性心力衰竭患者左房容积和功能的应用价值

Application value of four-dimensional echocardiography in evaluating quantitatively left atrial volume and function
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摘要 目的 探讨四维超声定量技术(4D LAQ)评价射血分数保留性心力衰竭(HFpEF)患者左房(LA)容积和应变功能变化的临床应用价值。方法 选取2021年1月~2022年6月于山东第二医科大学第一附属医院心内一科住院的50例HFpEF患者及同期30例健康体检者为研究对象。两组受试者应用常规超声心动图测量左室前后径、室间隔厚度、左室后壁厚度、左房前后径、左室射血分数(LVEF)、E峰、E’值、E/E’值;应用4D LAQ获取LA四维容积参数,如左房最小容积(LAV_(min))、左房最大容积(LAV_(max))、左房收缩前容积(LAV_(preA))、左房每搏量(LAEV)和左房射血分数(LAEF),以及LA心肌应变参数,如左室收缩期、舒张早期和舒张晚期的LA心肌纵向应变值(LASr、LAScd和LASct)和圆周峰值应变参数(LASr_c、LAScd_c和LASct_c);比较两组受试者的上述参数。结果 与正常对照组相比,病例组LA四维容积参数LAV_(min)、LAV_(max)、LAV_(preA)及LAEV明显增加,LAEF值显著降低(P<0.05);病例组LA应变参数LAScd、LASct、LASr_c、LAScd_c及LASct_c的绝对值增加,LASr降低(P<0.05);HFpEF患者的LAV_(min)、LAV_(max)、LAV_(preA)、LAEV与E/E’值呈正相关(P<0.05)。结论 4D LAQ可以有效评估HFpEF患者LA容积和功能变化,对HFpEF患者临床诊断、治疗和预后评估具有重要意义。 Objective To evaluate the clinical value of the four-dimensional echocardiography on the changes of left atrial(LA) volume and strain function in patients with heart failure with ejection fraction preserved(HFpEF).Methods Fifty patients with HFpEF hospitalized in the Department of Cardiology Ⅰ of the First Affiliated Hospital of Shandong Second Medical University from January 2021 to June 2022.The control group consisted of 30 healthy subjects who visited our hospital during the same period.Both groups of subjects accepted conventional echocardiography to measure left ventricular end-diastolic dimension,interventricular septal thickness,left ventricular posterior wall thickness,left atrial diameter,left ventricular ejection fraction(LVEF),E velocity,E' velocity and E/E' ratio.Both groups of subjects accepted four-dimensional left atrial quantification(4D LAQ) to obtain LA four-dimensional volume parameters,such as left atrial minimum volume(LAV_(min)),left atrial maximum volume(LAV_(max)),left atrial pre-systolic volume(LAV_(preA)),left atrial ejection volume(LAEV) and left atrial ejection fraction(LAEF),and to obtain LA strain parameters by 4D LAQ,such as LA longitudinal and circumferential strain during the left ventricular systole,the early diastole and late diastole,(LASr,LAScd,LASct,LASr_c,LAScd_c and LASct_c).Results Compared with the control group,LAV_(min),LAV_(max),LAV_(preA) and LAEV were all significantly increased in the case group,while the LAEF was significantly decreased(P<0.05).The absolute values of LAScd,LASct,LASr_c,LAScd_c and LASct_c were all significantly increased in the case group,while LASr was significantly decreased(P<0.05).Correlation analysis showed that LAV_(min),LAV_(max),LAV_(preA) and LAEV were positively correlated with E/E' ratio in HFpEF patients(P<0.05).Conclusion The four-dimensional echocardiography can effectively assess LA volume and functional changes in patients with HFpEF,which is important for clinical diagnosis,treatment and prognostic assessment.
作者 陈文东 赵云波 黄静 王曙光 伦宗怡 孙雨 王振 张爱元 CHEN Wendong;ZHAO Yunbo;HUANG Jing;WANG Shuguang;LUN Zongyi;SUN Yu;WANG Zhen;ZHANG Aiyuan(Department of Emergency Internal Medicine,the First Affiliated Hospital of Shandong Second Medical University,Weifang 261041,China;Department of Cardiology,the First Affiliated Hospital of Shandong Second Medical University;Department of Emergency Internal Medicine,Gaomi People' Hospital;Department of Cardiology,Sunshine Union Hospital)
出处 《潍坊医学院学报》 2024年第2期129-132,共4页 Acta Academiae Medicinae Weifang
关键词 四维超声心动图 心力衰竭 射血分数保留性心力衰竭 左房功能 左房容积 心肌应变 Four-dimensional echocardiography Heart failure Heart failure with preserved ejection fraction LA function LA volume Myocardial strain
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