| 摘要: |
| 目的：应用速度向量成像（Velocity Vector Imaging,VVI）技术对不同程度代谢综合征（Metabolic Syndrome，MS）患者左室舒张功能的改变进行评估，以期早期发现代谢综合征患者左室舒张功能的改变。
方法：选取30例健康体检人员及60例代谢综合征患者，根据患者血糖、血压升高的不同程度，将代谢综合征患者分为MS I组和MS II组。所有入选患者均进行常规超声心动图检查二维测量室间隔舒张末厚度(IVSd)、左室后壁舒张末厚度(LVPWd)，测量左室射血分数（EF%）；PW测量舒张期二尖瓣口血流频谱E峰、A峰；TDI模式下测量舒张早期二尖瓣内侧环频谱（e’）；应用速度向量成像技术测量左室各节段舒张早期峰值速度（Ve）及峰值应变率（SRe）。
结果：
1.1 MS I组和MS II组二尖瓣口血流E/A值均显著低于对照组（p＜0.01），差异有统计学意义；而MS I组与MS II组E/A值之间差异无统计学意义（p＞0.05）；
1.2 MS I组和MS II组二尖瓣内侧环E/e’值均显著高于对照组（p＜0.01），差异有统计学意义；且MS I组E/e’值亦显著高于MS II组（p＜0.01），差异有统计学意义。
2.1 MS I组左室各节段舒张早期峰值速度（Ve）均显著低于对照组（p＜0.01），MS II组Ve除了室间隔心尖段阴性外，其余均显著低于对照组（p＜0.01）；2.2 MS I组舒张早期峰值应变率（SRe）均低于对照组（p＜0.05），MS II组SRe除了后间隔中间段、下壁中间段及前壁中间段阴性外，其余均低于对照组（p＜0.05）；
2.3 MS I组及MS II组左室长轴二尖瓣环水平室间隔组织E/Ve值均显著高于对照组（p＜0.01），且MS I组E/Ve值亦显著高于MS II组（p＜0.01），三组间呈递减趋势。
结论：1.通过VVI技术测定左室各节段舒张早期峰值速度（Ve）与峰值应变率（SRe），能评估代谢综合征患者左室舒张功能障碍；2.代谢综合征患者在左室结构改变之前，通过VVI技术结合频谱多普勒二尖瓣口血流测定E/Ve值，可早期评估患者可能存在潜在的左室舒张功能异常，并能区分舒张功能的异常程度；3.VVI技术是一项无创、简便的心脏超声检查新技术，能够为准确评价代谢综合征患者左室舒张功能的改变提供可靠的依据。 |
| 关键词: 速度向量成像 超声心动图 左室舒张功能 代谢综合征 |
| DOI： |
| 投稿时间：2019-03-26修订日期：2019-03-26 |
| 基金项目:汕头市科技计划项目 |
|
| Evaluation of early left ventricular diastolic function in patients with metabolic syndrome by using Velocity Vector Imaging |
| caipeiwei |
| (The first affiliated hospital of shantou university medical College) |
| Abstract: |
| Objective:Velocity Vector Imaging (VVI) was used to evaluate left ventricular diastolic function in patients with different degrees of Metabolic Syndrome (MS) in order to detect changes in left ventricular diastolic function in patients with metabolic syndrome.
Methods: 30 healthy medical examiners and 60 patients with metabolic syndrome were selected. According to the different degrees of blood glucose and blood pressure, patients with metabolic syndrome were divided into MS I group and MS II group.All patients were enrolled in a conventional echocardiographic examination of two-dimensional measurement of interventricular septal thickness (IVSd), left ventricular posterior wall end-diastolic thickness (LVPWd), and left ventricular ejection fraction (EF%); PW measurement of diastolic mitral valve blood flow spectrum E peak, A peak; Measurement of early diastolic mitral medial ring spectrum (e’) in TDI mode; Measurement of early peak relaxation velocity (Ve) and peak strain rate (SRe) of left ventricular segments using velocity vector imaging.
Results:
1.1 The E/A values of mitral valve flow in MS I group and MS II group were significantly lower than those in the control group (p<0.01), and the difference was statistically significant; There was no significant difference in E/A between MS I and MS II (p>0.05);
1.2 The E/e' values of the medial ring of the mitral valve in MS I and MS II groups were significantly higher than those in the control group (p<0.01). The difference was statistically significant; The E/e' value of MS I group was also significantly higher than that of MS II group (p<0.01). The difference was statistically significant.
2.1 The peak diastolic velocity (Ve) of the left ventricle of MS I group was significantly lower than that of the control group (p<0.01), and the MS II group Ve was significantly lower than the control group except for the ventricular septal apex segment negative (p<0.01).
2.2 The peak strain rate (SRe) of early diastolic in MS I group was lower than that in the control group (p<0.05), and the MS II group SRe was lower than the control group except the middle segment of the posterior septum, the middle segment of the inferior wall and the middle segment of the anterior wall (p<0.05);
2.3 The E/Ve values of the left ventricular long axis mitral annulus in the MS I group and the MS II group were significantly higher than those in the control group (p<0.01), and the E/Ve values in the MS I group were also significantly higher than those in the MS II group. (p<0.01), there is a decreasing trend among the three groups.
Conclusions:
1.Determination of early peak diastolic velocity (Ve) and peak strain rate (SRe) in left ventricular segments by VVI technique, can assessment of left ventricular diastolic dysfunction in patients with metabolic syndrome;
2.Patients with metabolic syndrome before the left ventricular structure changes, the E/Ve value can be determined by VVI technique combined with spectral Doppler mitral valve blood flow, which can be used to assess potential left ventricular diastolic dysfunction and distinguish abnormal degree of diastolic function;
3.VVI technology is a non-invasive and simple new method of echocardiography, which can provide a reliable basis for accurate evaluation of left ventricular diastolic function in patients with metabolic syndrome. |
| Key words: Velocity Vector Imaging Echocardiography Left ventricular diastolic function Metabolic Syndrome |
