摘要
目的探讨心肌分层应变技术定量评价心力衰竭患者左心室心肌收缩功能的临床应用价值。方法60例心力衰竭患者根据左室射血分数(left ventricular ejection fraction,LVEF)分为LVEF<40%组、LVEF≥40%~<50%组和LVEF≥50%组,每组20例;选择同期体检健康者20例为对照组。4组均采集3个心动周期的左心室短轴基底段、中间段、心尖段及心尖四腔心、两腔心、三腔心切面的二维动态图像,应用分层应变技术测定左心室心内膜下、中层、心外膜下心肌整体纵向应变(global longitudinal strain,GLS)及整体圆周应变(global circumferential strain,GCS)并进行统计分析,分析应变值与LVEF的相关性。结果LVEF≥50%组、LVEF≥40%~<50%组、LVEF<40%组患者GLSendo、GLSmid、GLSepi、GCSendo、GCSmid、GCSepi均低于对照组(P<0.05)。LVEF≥50%组和LVEF≥40%~<50%组GLSendo、GLSmid、GLSepi、GCSendo均高于LVEF<40%组(P<0.05),LVEF≥50%组与LVEF≥40%~<50%组比较差异无统计学意义(P>0.05);LVEF<40%组患者GCSmid、GCSepi低于LVEF≥50%组(P<0.05),与LVEF≥40%~<50%组比较差异无统计学意义(P>0.05),LVEF≥40%~<50%组与LVEF≥50%组比较差异均无统计学意义(P>0.05)。LVEF与GLSendo、GLSmid、GLSepi(r=-0.75,P<0.001;r=-0.74,P<0.001;r=-0.75,P<0.001)和GCSendo、GCSmid、GCSepi(r=-0.75,P<0.001;r=-0.72,P<0.001;r=-0.64,P<0.001)均呈负相关。结论分层应变技术可定量评价心力衰竭患者左心室心肌功能;纵向应变、圆周应变可早期反映左心室心肌收缩功能和损伤程度。
Objective To explore the clinical value of myocardial layer-specific strain technique to the detection of early heart failure by quantitatively evaluating the left ventricular systolic function.Methods Sixty patients with heart failure were divided into left ventricular ejection fraction(LVEF)<40% group,LVEF≥40%-<50% group,and LVEF≥50% group,with 20 patients in each group,and another 20 healthy volunteers were as controls(control group).Two-dimensional dynamic images of the short-axis basal,middle and apical,as well as apical four-,two-and three-chamber views of the left ventricle for three cardiac cycles were collected in four groups.The global longitudinal strain(GLS)and global circumferential strain(GCS)in endocardium,mid-cardium and epi-cardium(GLSendo,GLSmid,GLSepi;GCSendo,GCSmid,GCSepi)were measured by using strain-layering technique to analyze the correlation between the strain values and LVEF.Results The GLSendo,GLSmid,GLSepi,GCSendo,GCSmid and GCSepi were lower in LVEF≥50% group,LVEF≥40%-<50% group and LVEF<40% group than those in control group(P<0.05).The GLSendo,GLSmid,GLSepi and GCSendo were higher in LVEF≥50% group and LVEF≥40%-<50% group than those in LVEF<40% group(P<0.05),and showed no significant differences between LVEF≥50% group and LVEF≥40%-<50% group(P>0.05).The GCSmid and GCSepi were lower in LVEF<40% group than those in LVEF≥50% group(P<0.05),and showed no significant difference between LVEF<40% group and LVEF≥40%-<50% group(P>0.05)and between LVEF≥40%-<50% group and LVEF≥50% group(P>0.05).LVEF was negatively correlated with GLSendo(r=-0.75,P<0.001),GLSmid(r=-0.74,P<0.001),GLSepi(r=-0.75,P<0.001),GCSendo(r=-0.75,P<0.001),GCSmid(r=-0.72,P<0.001)and GCSepi(r=-0.64,P<0.001).Conclusion Layer-specific strain technique can quantitatively evaluate left ventricular myocardial function in patients with heart failure.GLS and GCS could reflect myocardial injury and its severity.
作者
胡彦斌
刘园园
崔存英
李亚南
王莹
刘琳
HU Yanbin;LIU Yuanyuan;CUI Cunying;LI Yanan;WANG Ying;LIU Lin(Department of Ultrasound,Henan Provincial People's Hospital,Central China Fuwai Hospital,Central China Fuwai Hospital of Zhengzhou University,Zhengzhou 450003,China)
出处
《中华实用诊断与治疗杂志》
2020年第6期619-622,共4页
Journal of Chinese Practical Diagnosis and Therapy
基金
国家自然科学基金(81401419)
河南省科技厅科技攻关项目(17210231003)
河南省医学科技攻关计划项目(2018020452)。
关键词
心力衰竭
心肌分层应变
左心室功能
纵向应变
圆周应变
heart failure
layer-specific strain technique
left ventricular function
longitudinal strain
circumferential strain
作者简介
通信作者:刘琳,E-mail:liulin_819@126.com。
