| 摘要: |
| 目的:应用二维斑点追踪技术（2DSTI）评价左心房整体纵向峰值应变（GLAS）对重度主动脉瓣狭窄(AS)患者危险分层的预测价值。方法:选取85例左心室射血分数≥50%的重度主动脉瓣狭窄患者，行常规超声心动图测量和2DSTI分析，获得常规超声心动图参数及GLAS。对所有患者进行一年的随访，随访终点是患者NYHA心功能III级及以上；复查NT-proBNP水平大于450pg/mL（<45岁），大于900 pg/mL（50-75岁），大于1800 pg/mL（>75岁），因心力衰竭而住院，出现晕厥或因心血管事件死亡。应用多因素逻辑回归分析临床资料、常规超声心动图指标以及应变参数与AS患者预后的相关性，探讨影响患者预后的最佳指标。结果: 经过一年随访，共34 例（40%）患者达到临床随访终点。发生事件组的LVEF、主动脉瓣面积和GLAS均显著低于维持正常组，糖尿病、心力衰竭的患病率、E/e’、LAVImax明显高于维持正常组。多因素回归分析结果表明，GLAS是预测AS患者出现不良心血管事件的独立指标。结论: 2DSTI技术能反应左心房功能的改变，且GLAS是评估无症状重度AS患者危险分层及预后的的预测指标，GLAS降低提示患者出现不良心脏事件风险增高，及时予以干预，将有助于降低患者死亡率，改善预后。
关键词:主动脉瓣狭窄；斑点追踪应变成像技术；危险分层；左心房 |
| 关键词: 主动脉瓣狭窄 斑点追踪应变成像技术 危险分层 左心房 |
| DOI： |
| 投稿时间：2017-09-10修订日期：2017-10-14 |
| 基金项目: |
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| Usefulness of Speckle Tracking Imaging for Risk Stratification in Asymptomatic Severe Aortic Stenosis.Duan Tongqing 1, Wu Yongjian 2 ,Zheng Huijuan 1(1 、 Department of ultrasound, Qingdao Fuwai Cardiovascular Disease Hospital, Shandong 266034, |
| Duan-Tongqing |
| () |
| Abstract: |
| Objective: The aim of the study was to assess the predictive value of global left atrial longitudinal strain (GLAS) for risk stratification in patients with asymptomatic severe aorta stenosis (AS) by two-dimensional speckle tracking imaging (2DSTI). Methods: A total of 85 severe AS patients with preserved left ventricular ejection fraction (LVEF≥50%) were included in our cohort, all patients were performed echocardiography and strain analyze to measure the conventional echocardiography parameters and GLAS. All patients were followed-up for one year, and the endpoints of follow-up were patients presented with heart failure: NYHA III-IV, NT-proBNP level greater than 450pg/mL (<45 years old), greater than 900pg/mL (50-75 years old), greater than 1800pg/mL (>75 years old), hospitalized due to heart failure, syncope, or death from cardiovascular events. Multivariate logistic regression analysis was used to analyze the correlation between clinical data, conventional echocardiographic parameters and GLAS, to explore the best predictors in the long-term follow-up. Result: After a year of follow-up, 34 patients (40%) reached one of the endpoints. Patients with events showed lower LVEF, aortic valve area, and GLAS than those maintenance asymptomatic group；However, the prevalence of diabetes and heart failure, E/e’ and LAVImax were significantly higher than those in the maintenance asymptomatic group. Multivariate regression analyze show that GLAS was the only independent predictors of adverse cardiovascular events in AS patients.Conclusion: 2DSTI can synthesize evaluate the changes of LA functions, and GLAS was the best indicator for predicting the risk stratification and prognosis in patients with asymptomatic severe AS. Impaired GLAS was associated with high risk of adverse cardiac events. This parameter may help to reduce the mortality of patients, and so improve the prognosis.
[Keywords] Aortic stenosis; Speckle tracking imaging; Risk stratification；Left atrial |
| Key words: Aortic stenosis Speckle tracking imaging Risk stratification Left atrial |
