| 摘要: |
| 目的 探索三维超声斑点追踪技术（3D-STE）评价高血压合并和不合并舒张功能障碍的患者临床应用价值。资料与方法 选取左室射血分数正常（LVEF>54%）的原发性高血压患者58例为高血压组，并分为左室舒张功能正常组（HTDD-negative groups，27例）和左室舒张功能减低组（HTDD-positive group，31例）两个亚组，同时入选健康体检正常组30人作为对照组。所有患者行常规超声心动图检查采集图像获得二维参数的同时，采取新建全容积图像，应用3D-STE获得各组三维参数左室整体纵向收缩峰值应变（GLS）、左室整体圆周收缩峰值应变（GCS）、左室整体径向收缩峰值应变（GRS）。结果 高血压组患者GLS的绝对值均显著低于对照组（P<0.05），高血压组与对照组相比GCS和GRS的差异没有统计学意义（P>0.05）。Pearson 相关性分析GLS、GCS、GRS与左室质量指数（LVMI）的r值分别为0.56，0.09，-0.12，GLS与LVMI的相关性显著(P<0.05)，GCS和GRS与LVMI的没有明显相关性（P>0.05）。结论 在高血压左室收缩功能正常的患者中，首先损伤的是纵向排列的心肌导致左室纵向收缩功能下降。高血压患者无论是否合并舒张功能障碍，左室心内膜纵向心肌都已受损导致GLS减低，当发生舒张功能障碍时GLS减低更明显。 |
| 关键词: 三维斑点追踪技术 高血压 左室舒张功能 |
| DOI： |
| 投稿时间：2018-11-21修订日期：2018-11-25 |
| 基金项目:沈阳市科技计划项目（17-230-9-99） |
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| Clinical Application of Three-dimensional Speckle-tracking Echocardiography in Hypertension Patients With and Without Diastolic Dysfunction |
| li ying,zhu fang |
| () |
| Abstract: |
| Purpose To explore the application value of three-dimensional speckle-tracking（3D-STE）in evaluating hypertension patients with and without diastolic dysfunction. Materials and methods We selected a total of 58 essential hypertensive patients with preserved left ventricular ejection fraction (LVEF>50%). Echocardiography revealed no left ventricular diastolic dysfuction 27 out of 58 patients with hypertention (HTDD-negative group) and 31 out of 58 patients had diastolic dysfuction (HTDD-positive group). They were compared to a control group of 30 normotensive subjects. All the selected patients were for routine echocardiography and three-dimensional speckle tracking technique. Then we could obtain the parameters which we wanted, such as GLS(global longitudinal strain), GCS(global circumferential strain) and GRS(global radial strain). Results The absolute value of GLS in hypertensive group was significantly lower than that in control group（P<0.01）. GLS is positively correlated with left ventricular mass index (LVMI) (r=0.56, P<0.05). The correlation between GCS ,GRS and LVMI was not significant(P>0.05). Conclusion In hypertensive patients with normal left ventricular systolic function, first damage the most susceptible longitudinally arranged subendocardial myocardial fibres that will result in impaired longitudinal. In hypertension patients with and without diastolic dysfunction, left ventricular endocardial longitudinal myocardium has been damaged resulting in reduced GLS, when diastolic dysfunction occurs GLS will decaese more obviouse . |
| Key words: Three-dimensional speckle-tracking,Hypertension,Left ventricular diastolic dysfunction |
