速度向量成像技术评价心血管疾病高危病人左心室收缩功能的临床研究

目的应用速度向量成像(VVI)技术评价心血管疾病高危病人左心室收缩功能,并分析其与心血管疾病高危因素的关系。方法选取85例心血管疾病高危病人为高危组,同期健康体检者50名为对照组,常规超声心动图获取左房收缩末期内径(LAESD)、左室舒张末期内径(LVEDD)、室间隔厚度(IVS)、左室后壁厚度(LVPW)及左室射血分数(LVEF)。并采集心尖四腔、三腔、二腔长轴二维图像,测量各节段及整体纵向收缩峰值应变(GLS),分析左心室GLS与三酰甘油(TG)、低密度脂蛋白胆固醇(LDL-C)及收缩压、舒张压的相关性。结果高危组各亚组LVEF、LVEDD、LAESD、IVS、LVPW值与对照组比较,差异均无统计学意义(P>0.05);高危组左心室GLS(21.83±1.80)%,小于对照组的(23.00±1.97)%,差异有统计学意义(P<0.05)。相关分析显示,左心室整体平均纵向应变值与TG、LDL-C及收缩压、舒张压均无明显相关性(r=-0.148,P=0.086;r=-0.168,P=0.052;r=-0.098,P=0.260;r=-0.075,P=0.386)。结论VVI可通过心肌纵向应变评价左室心肌的收缩功能,发现心血管疾病高危病人的亚临床左心收缩力异常。

The Assessment of Left Ventricular Systolic Function in Patients with High Risk of Cardiovascular Disease by Velocity Vector Imaging

Objective To evaluate left ventricular systolic function in patients with high risk of cardiovascular disease by velocity vector imaging(VVI),and to analyze its relationship with cardiovascular risk factors.Methods Eighty-five high-risk cardiovascular patients were selected as the high-risk group,and fifty healthy people were selected as the control group.Left atrial end systolic diameter(LAESD),left ventricular end diastolic diameter(LVEDD),interventricular septal thickness(IVS),Left ventricular posterior wall thickness(LVPW),and left ventricular ejection fraction(LVEF)were obtained by echocardiography.Two-dimensional images were recorded from the apical four-chamber,three-chamber,and two-chamber long axis.The global and segmental myocardial longitudinal strains were measured.The relationship between global longitudinal strain(GLS)and triacylglycerol(TG),low density lipoprotein cholesterin(LDL-C),systolic pressure,and diastolic pressure was analyzed.Results There were no significant differences in LVEF,LVEDD,LAESD,IVS,LVPW between high-risk group and control group(P>0.05).The GLS of left ventricle in high-risk group was lower than that in control group(21.83±1.80)%vs(23.00±1.97)%,P<0.05].Correlation analysis results showed that there was no significant relation between GLS of left ventricle and TG,LDL-C,systolic pressure,and diastolic pressure(r=-0.148,P=0.086;r=-0.168,P=0.052;r=-0.098,P=0.260;r=-0.075,P=0.386).Conclusion VVI can evaluate the left ventricular systolic function by evaluating the longitudinal strain of myocardium,and find subclinical systolic abnormalities in patients with high risk of cardiovascular disease.