| 摘要: |
| 摘要
目的 应用二维斑点追踪超声心动图(2D-STE)评估慢性重度主动脉瓣反流(AR)患者左室纵向分层应变特点，并探讨其与左室构型之间的相关性。
方法 前瞻性纳入43例慢性重度AR患者以及20例健康志愿者进行二维超声心动图测量，留存图像后进行分层应变分析，得到左室整体及各节段心内膜下、中层及心外膜下心肌纵向应变(LSendo、LSmid和LSepi），整体纵向分层应变跨壁梯度(Transmural gradient, TG)，比较AR组与对照组之间各参数的差异，并分析左室整体纵向分层应变与构型之间的相关性。
结果 与对照组相比，AR组左室舒张末期内径指数(LVEDDI)、左室收缩末期内径指数(LVESDI)、左室舒张末期容积指数(LVEDVI)、左室收缩末期容积指数(LVESVI)、后壁厚度(PWT)、室间隔厚度(IVST)、左房前后径(LAD)、左室质量指数(LVMI)和球形指数(SPI)增大，而左室射血分数(LVEF)显著减低（P＜0.001）；AR组整体LSendo、LSmid、LSepi及TG均明显减低（P＜0.001），整体LSendo、LSmid、LSepi递减趋势消失；由基底部至心尖部，AR组LSendo递增趋势消失，LSmid和LSepi呈递减趋势（P＜0.05）。左室整体纵向分层与构型参数之间存在较好的负性相关关系（P＜0.001）。
结论 2D-STE能够定量评估慢性重度AR患者心肌纵向分层应变及收缩模式的改变，对于慢性重度AR患者的治疗具有重要指导意义。 |
| 关键词: 主动脉瓣反流 斑点追踪 重构 分层应变 |
| DOI： |
| 投稿时间：2021-08-04修订日期：2021-09-06 |
| 基金项目: |
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| Evaluation of the Characteristics of Longitudinal Layer-specific Strain of Left Ventricular and the correlation with Geometry of patients with Aortic Regurgitation by Two-dimensional Speckle Tracking Echocardiography |
| Gong Min,Wu Juan,Pei Yongkai,Wang Yanli,Cao Siqi,Wu Haibo,Wu Jun |
| (Department of Cardiovascular Ultrasound,the second Affiliated Hospital of Dalian Medical University,Dalian,Liaoning) |
| Abstract: |
| Abstract
Objectives: To evaluate the characteristics of longitudinal layer-specific strain of Left Ventricular (LV) in patients with chronic severe aortic regurgitation (AR) by two-dimensional speckle tracking echocardiography (2D-STE), and to explore the correlation between longitudinal layer-specific strain and geometry. Methods: Forty-three patients with chronic severe AR and 20 healthy volunteers were prospectively selected for traditional two-dimensional echocardiographic measurement. The global and segmental longitudinal strain of endocardial (LSendo), mid-myocardial (LSmid), epicardial (LSepi), and global longitudinal layer-specific strain transmural gradient (TG) acquired by 2D-STE. The difference of parameters between the control group and the AR group was compared, and the correlation between global longitudinal layer-specific strain and geometry was analyzed. Results: (1) Compared with the control group, the LV end-diastolic diameter index (LVEDDI), LV end-systolic diameter index (LVESDI), LV end-diastolic volume index (LVEDVI), LV end-systolic volume (LVESVI), Posterior wall thickness (PWT), Interventricular septum thickness (IVST), Left atrial dimension (LAD), LV mass index (LVMI) and Spherical index (SPI) were significantly increased in the AR group, while the LV ejection fraction (LVEF) was decreased (P < .001); (2) The global LSendo, LSmid, LSepi and TG in the AR group were lower than those in the control group (P < .001). (3) In the AR group, there was no significant difference in the longitudinal strain (LS) from endocardial to epicardial. From the base to the apex, the increasing trend of the LSendo disappeared, and the LSmid and LSepi were decreasing. (4) There was negative correlation between the LV global longitudinal layer-specific strain and the geometric parameter (P < .001). Conclusions: The changes of value and pattern of longitudinal layer-specific strain of LV in patient with chronic severe AR can be quantitatively evaluated by 2D-STE which has important guiding value for the treatment of patients with chronic severe AR. |
| Key words: Aortic regurgitation, Speckle tracking, Remodeling, Layer-specific strain |
