摘要
目的 探讨超声心动图应变分析对高血压左心室肥厚(H-LVH)与心脏淀粉样变(CA)的鉴别价值。方法 将海军军医大学附属第一医院自2021年6月至2023年6月收治的45例CA患者纳入A组。另将我院同期收治的50例H-LVH患者纳入B组。记录并比较两组患者传统超声心动图参数[左心房内径(LAd)、左心房最大容积指数(LAVI)、舒张末期左心室内径(LVEDD)、舒张末期室间隔厚度(IVS)、舒张末期左心室后壁厚度(LVPW)、二尖瓣口舒张早期血流峰值/舒张晚期血流峰值(E/A)、二尖瓣口舒张早期血流峰值/二尖瓣环室间隔侧舒张早期峰值(E/e′)、左心室射血分数(LVEF)]。记录并比较两组患者超声心动图应变参数[左心室整体长轴应变(GLS)、左心房峰值应变(LASr)、收缩期应变率(SRs)、左心房管道期应变(LAScd)、舒张早期应变率(SRe)、左心房晚期峰值应变(LASct)及舒张晚期应变率(SRa)]。应用最小绝对收缩和选择算子回归建立鉴别诊断模型。绘制受试者工作特征(ROC)曲线评价传统参数模型、联合模型对CA、H-LVH的鉴别价值。结果 A组患者IVS、LVPW、E/A、E/e′均高于B组,差异均有统计学意义(P<0.05)。A组患者GLS、LASr、SRs、LASct、SRa均低于B组,差异均有统计学意义(P<0.05)。传统参数模型、联合模型鉴别CA及H-LVH的ROC曲线下面积分别为0.854、0.916,敏感度分别为0.788、0.818,特异度分别为0.946、0.958。结论 在超声心动图的传统参数基础上结合应变参数可提高对CA及H-LVH的鉴别价值。
Objective To investigate the value of strain analysis of echocardiography in differentiating hypertensive-left ventricular hypertrophy(H-LVH)from cardiac amyloidosis(CA).Methods A total of 45 patients with CA admitted to the First Affiliated Hospital of Naval Medical University from June 2021 to June 2023 were included in Group A.In addition, 50 patients with H-LVH admitted to our hospital during the same period were included in group B.Traditional echocardiographic parameters were recorded and compared between the two groups[left atrial diameter(LAd),left atrial volume index(LAVI),left ventricular end diastolic diameter(LVEDD),interventricular septal thickness at diastole(IVS),left ventricular posterior wall thickness(LVPW),early diastole peak flow velocity/late diastolic peak flow velocity(E/A),early diastole peak flow velocity/early diastolic mitral annular velocity(E/e′),left ventricular ejection fraction(LVEF)].The echocardiographic strain parameters were recorded and compared between the two groups[global longitudinal strain(GLS),left atrial reservoir strain(LASr),systolic strain rate(SRs),left atrial strain conduit phase(LAScd),early diastolic strain rate(SRe),left atrial strain contraction phase(LASct),late diastolic strain rate(SRa)].The differential diagnosis model was established by least absolute shrinkage and selection operator regression.Receiver operating characteristic(ROC)curve was drawn to evaluate the identification value of traditional parameter model and combined model for CA and H-LVH.Results IVS,LVPW,E/A and E/e′ in group A were higher than those in group B,with statistical significance(P<0.05).GLS,LASr, SRs, LASct and SRa in group A were lower than those in group B,and the differences were statistically significant(P<0.05).The area under ROC curve of traditional parameter model and combined model for identifying CA and H-LVH were 0.854 and 0.916,sensitivity were 0.788 and 0.818,and specificity were 0.946 and 0.958,respectively.Conclusion Combining the traditional parameters of echocard
作者
金琪
黄松群
梁颖
JIN Qi;HUANG Song-qun;LANG Ying(Department of Ultrasound,The First Afiliated Hospital of Naval Medical University,Shanghai 200433,China;Department of Cardiology,The First Afiliated Hospital of Naval Medical University,Shanghai 200433,China)
出处
《临床军医杂志》
CAS
2024年第5期460-463,共4页
Clinical Journal of Medical Officers
基金
国家自然科学基金项目(82000283)。
关键词
心脏淀粉样变
高血压
左心室肥厚
超声心动图
应变分析
Cardiac amyloidosis
Hypertension
Left ventricular hypertrophy
Echocardiography
Strain analysis
