摘要
目的探讨联合超声心动图与三维斑点追踪技术(3D-STI)对心肌淀粉样变(CA)和肥厚型心肌病(HCM)的诊断价值。方法选择2019年9月至2023年9月郑州大学附属郑州中心医院收治36例CA患者(CA组)和36例HCM患者(HCM组)为研究对象,另选择来郑州大学附属郑州中心医院体检的36名健康人群为对照组。采用多普勒超声心动图仪检测3组患者超声心动图参数[左心室射血分数(LVEF)、左心房容积指数(LAVI)、舒张早期二尖瓣血流速度/二尖瓣环运动速度(E/e′)、左心室最大室壁厚度(MLVWT)、室间隔厚度(IVS)、左心室收缩末期内径(LVSED)、左心室舒张末期内径(LVEDD)]和3D-STI参数[左心室三维整体圆周应变(GCS)、径向应变(GRS)、纵向应变(GLS)、面积应变(GAS)、纵向应变达峰时间标准差(Ts-SD-GLS)],采用受试者操作特征(ROC)曲线分析各参数对CA和HCM的诊断价值。结果CA组、HCM组患者的LVEF显著低于对照组,LAVI、E/e′、MLVWT、IVS、LVSED、左心房增大患者占比显著高于对照组(P<0.05),CA组左心房增大患者占比、双房增大患者占比、心包积液患者占比显著高于对照组,LVEDD显著低于对照组(P<0.05);HCM组患者的LVEF、LAVI、MLVWT、IVS、LVEDD、左心房增大患者占比显著高于CA组,E/e′、LVSED、双房增大患者占比、心包积液患者占比显著低于CA组(P<0.05)。ROC曲线显示,LAVI、E/e′、MLVWT、IVS、左心房增大、双房增大、心包积液诊断CA的曲线下面积(area under the curve,AUC)分别为0.880、0.972、0.946、0.995、0.694、0.792、0.903;LAVI、E/e′、MLVWT、IVS、LVEDD诊断HCM的AUC分别为0.925、0.984、0.944、0.971、0.553。CA组和HCM组患者的GCS、GRS、GLS、GAS绝对值显著低于对照组,Ts-SD-GLS水平显著高于对照组(P<0.05);CA组患者Ts-SD-GLS水平显著高于HCM组(P<0.05)。ROC曲线显示,GCS、GRS、GLS、GAS、Ts-SD-GLS诊断CA的AUC分别为0.828、1.000、0.993、0.838、1.000;GCS、GRS、GLS、GAS、Ts-SD-
Objective To investigate the diagnostic value of echocardiography combined with three-dimensional speckle tracking imaging(3D-STI)for cardiac amyloidosis(CA)and hypertrophic cardiomyopathy(HCM).Methods Thirty-six patients with CA(CA group)and 36 patients with HCM(HCM group)who were treated at Zhengzhou Central Hospital affiliated to Zhengzhou University from September 2019 to September 2023 were selected as the research subjects.In addition,36 healthy individuals who did health check-ups at Zhengzhou Central Hospital affiliated to Zhengzhou University were selected as a control group.All patients in the three groups were tested using Doppler echocardiography to measure echocardiographic parameters[left ventricular ejection fraction(LVEF),left atrial volume index(LAVI),early diastolic mitral flow velocity/early diastolic mitral annulus velocity(E/e′),maximum left ventricular wall thickness(MLVWT),interventricular septum thickness(IVS),left ventricular end-systolic diameter(LVSED),left ventricular end-diastolic diameter(LVEDD)]and 3D-STI parameters[left ventricular three-dimensional global circumferential strain(GCS),global radial strain(GRS),global longitudinal strain(GLS),global area strain(GAS),and standard deviation of systolic peak time-GLS(Ts-SD-GLS)].The diagnostic value of each parameter for CA and HCM was analyzed using a receiver operating characteristic(ROC)curve.Results Compared with the control group,LVEF decreased,while LAVI,E/e′,MLVWT,IVS,LVSED,and the proportion of patients with enlarged left atrium increased in the CA group and HCM group(P<0.05).The proportions of patients with enlarged left atrium,enlarged atria,and pericardial effusion in the CA group were significantly higher than those in the control group,while the LVEDD was significantly lower than that in the control group(P<0.05).LVEF,LAVI,MLVWT,IVS,LVEDD,and the proportion of patients with enlarged left atrium in the HCM group were significantly higher than those in the CA group,while E/e′,LVSED,and the proportions of patients with e
作者
田园
闫媛媛
史海宏
TIAN Yuan;YAN Yuanyuan;SHI Haihong(Department of Ultrasound Medicine,Zhengzhou Central Hospital Affiliated to Zhengzhou University,Zhengzhou 450000,Henan Province,China)
出处
《新乡医学院学报》
CAS
2024年第9期840-846,共7页
Journal of Xinxiang Medical University
关键词
心肌淀粉样变
肥厚型心肌病
超声心动图
三维斑点追踪技术
鉴别诊断
cardiac amyloidosis
hypertrophic cardiomyopathy
echocardiography
three-dimensional speckle tracking imaging
differential diagnosis
