摘要
目的 探讨三维斑点追踪(3D-STI)技术评估缺血性二尖瓣反流(IMR)患者左心房功能变化中的价值。方法 选择2021年2月至2023年6月于内江市第一人民医院行3D-STI检查的冠状动脉粥样硬化性心脏病(冠心病)患者143例,根据超声检查是否合并IMR分为冠心病组(55例)和IMR组(88例),另选择62例健康体检者为对照组。比较各组3D-STI参数差异,分析3D-STI参数与左心房射血功能相关性以及诊断IMR的价值。结果 IMR组左心房前后径、左房左右径及左房上下径、左心室舒张末期内径及收缩末期内径、最大左心房容积,波谷点为最小左心房容积,收缩前左心房容积大于冠心病组和对照组(P<0.05),左室射血分数(LVEF)、左心房总射血分数(LATEF)、左心房被动排空分数(LAVpEF)、左心房主动射血分数(LAaEF)、左心房整体纵向应变(GLS)、圆周应变(GCS)及径向应变(GRS)低于冠心病组和对照组(P<0.05)。IMR组患者GLS、GCS、GRS与LATEF、LAVpEF、LAaEF均呈正相关(P<0.05)。GLS诊断IMR的曲线下面积(AUC)为0.715(95%CI:0.633~0.787,P<0.001);GCS诊断IMR的AUC为0.644(95%CI:0.559~0.722,P<0.001);GRS诊断IMR的AUC为0.643(95%CI:0.558~0.721,P<0.001);三者联合诊断IMR的AUC为0.882(95%CI:0.818~0.930,P<0.001);三者联合诊断IMR的AUC高于GLS、GCS、GRS单独诊断(P<0.001)。结论 3D-STI可准确评估冠心病IMR患者左房功能变化,GLS、GCS、GRS可作为鉴别IMR的指标。
Objective To discuss the value of three-dimensional speckle tracking imaging(3D-STI)in assessing changes of left atrial function in patients with ischemic tricuspid regurgitation(IMR).Methods The patients with coronary heart disease(CHD)undergone 3D-STI examination(n=143)were chosen from the First People’s Hospital of Neijiang City from Feb.2021 to June 2023.The patients were divided,according to ultrasound examination results,into CHD group(n=55)and IMR group(n=88).Meanwhile the volunteers with physical examination(n=62)were selected into control group.The difference in 3D-STI parameter were compared among 3 groups,and correlation between 3D-STI and left atrial ejection function(LAEF)and value of 3D-STI parameter in IMR diagnosis were analyzed.Results In IMR group,left atrial anteroposterior diameter(LAAPD),left atrial mediolateral diameter(LAMLD),left atrial suproinferior diameter(LASID),left ventricular end-diastolic diameter(LVEDd),left ventricular end-systolic diameter(LVESd),maximum left atrial volume(LAVmax),minimum left atrial volume(LAVmin)at trough point and pre-systolic left atrial volume were higher than those in CHD group and control group(P<0.05),and left ventricular ejection fraction(LVEF),left atrial total ejection fraction(LATEF),left atrial passive ejection fraction(LAVpEF),left atrial active ejection fraction(LAaEF),and global longitudinal strain(GLS),global circumferential strain(GCS)and global radial strain(GRS)of left atrium were lower(P<0.05)than those in CHD group and control group.GLS,GCS and GRS were positively correlated to LATEF,LAVpEF and LAaEF in IMR group(P<0.05).In IMR diagnosis,AUC of GLS was 0.715(95%CI:0.633-0.787,P<0.001),AUC of GCS was 0.644(95%CI:0.559-0.722,P<0.001),AUC of GRS was 0.643(95%CI:0.558-0.721,P<0.001),and AUC of combination of GLS,GCS and GRS was 0.882(95%CI:0.818-0.930,P<0.001).AUC of combination of GLS,GCS and GRS was higher than that of single GLS,GCS and GRS in IMR diagnosis(P<0.001).Conclusion 3D-STI can accurately assess the changes of left atrial function in CHD patients with IMR,and GLS,GCS and GRS can be taken as indicators for distinguishing IMR.
作者
程晓萍
万野
张清连
祝春梅
邱敏
Cheng Xiaoping;Wan Ye;Zhang Qinglian;Zhu Chunmei;Qiu Min(Department of Ultrasound Medicine,First People’s Hospital of Neijiang City,Neijiang 641100,China;不详)
出处
《中国循证心血管医学杂志》
2024年第8期965-968,共4页
Chinese Journal of Evidence-Based Cardiovascular Medicine
基金
四川省医学科研课题(2019TG12)。
关键词
冠心病
三维斑点追踪技术
缺血性二尖瓣反流
左房射血分数
心肌应变
Coronary heart disease
Three-dimensional speckle tracking imaging
Ischemic tricuspid regurgitation
Left atrial ejection fraction
Myocardial strain
作者简介
通讯作者:程晓萍,E-mail:15983275001@163.com。
