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三维斑点追踪技术在不同危险分层主动脉狭窄患者诊断中的应用 |
姜美廉,巍珊,王正义 |
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(海口市人民医院滨江分院) |
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摘要: |
目的: 探索三维斑点追踪技术(3D-STI)在不同危险分层主动脉狭窄(AS)患者诊断中的应用价值。方法:选择我院2020年1月至2021年12月收治的79例AS患者及同期36例健康志愿者作为研究对象,根据AS危险程度分为对照组36例、轻度组30例、中度组25例及重度组24例。四组研究对象均进行常规超声和3D-STI检查,常规超声检测舒张末期左心室后壁厚度(LVPWT)、左心室舒张末期内径(LVEDD)、左心室射血分数(LVEF)、舒张末期室间隔厚度(IVST)及左室收缩末期内径(LVSD);3D-STI检查整体面积应变(GAS)、LVEF、整体环向应变(GCS)、总体径向应变(GRS)、整体纵向应变(GLS)、3D-strain、扭矩、扭曲及旋转;采用Spearman分析AS危险程度与3D-STI检查参数之间相关性。结果:常规超声检测显示,重度组LVPWT、IVST水平均明显高于其他三组(P<0.05);3D-STI检测显示,中度组和重度组中GCS水平明显高于其他两组,GRS、GLS水平均明显低于其他两组,且重度组各指标变化幅度高于中度组(P<0.05);三组患者中3D-strain水平明显低于对照组,且扭矩、扭曲及旋转水平均明显高于对照组(P<0.05);; AS危险程度与LVPWT、IVST、GCS、扭矩、扭曲及旋转均呈正相关(rLVPWT=0.522,PLVPWT=0.000;rIVST=0.648,P IVST =0.000;rGCS=-0.637,PGCS=0.000;r扭矩=0.552,P扭矩=0.000;r扭曲=0.523,P扭曲=0.000;r旋转=0.648,P旋转=0.000),与GRS、GLS及3D-strain呈负相关(rGRS=-0.680,PGRS=0.000;r GLS=-0.581,PGLS =0.000;r 3D-strain=0.700,P3D-strain=0.000)。结论:AS危险程度越高,对心脏功能损伤也会越大,3D-STI可以在早期对其进行危险程度评估,效果良好。 |
关键词: 三维斑点追踪技术 主动脉狭窄 危险分层 |
DOI: |
投稿时间:2022-05-13修订日期:2022-05-13 |
基金项目: |
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Application of three-dimensional speckle tracking imaging in the diagnosis of patients with aortic stenosis of different risk stratification |
jiangmeilian,weishan,wnagzhengyi |
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Abstract: |
Objective: To explore the application value of three-dimensional speckle tracking imaging (3D-STI) in the diagnosis of patients with aortic stenosis (AS) of different risk stratification. Methods: A total of 79 patients with AS admitted to the hospital and 36 healthy volunteers were enrolled as research objects between January 2020 and December 2021. According to the severity of AS, they were divided into control group (36 cases), mild group (30 cases), moderate group (25 cases) and severe group (24 cases). All underwent routine ultrasound and 3D-STI examinations. The left ventricular posterior wall thickness (LVPWT), left ventricular end-diastolic diameter (LVEDD), left ventricular ejection fraction (LVEF), interventricular septum thickness (IVST) and left ventricular end-systolic diameter (LVSD) were detected by routine ultrasound. The global area strain (GAS), LVEF, global circumferential strain (GCS), global radial strain (GRS), global longitudinal strain (GLS), 3D-strain, torque, twist and rotation were detected by 3D-STI. The correlation between AS severity and 3D-STI parameters was analyzed by Spearman analysis. Results: The routine ultrasound showed that levels of LVPWT and IVST in severe group were significantly higher than those in the other three groups (P<0.05). 3D-STI showed that GCS in moderate group and severe group was significantly higher than that in the other two groups, while levels of GRS and GLS were significantly lower than those in the other two groups. The above changes were more significant in severe group than moderate group (P<0.05). 3D-strain level in the three groups was significantly lower than that in control group, while torque, twist and rotation were significantly higher than those in control group (P<0.05). The severity of AS was positively correlated with LVPWT, IVST, GCS, torque, twist and rotation (rLVPWT=0.522, PLVPWT=0.000; rIVST=0.648, PIVST=0.000; rGCS=-0.637, PGCS=0.000; rtorque=0.552, Ptorque=0.000; rtwist=0.523, Ptwist=0.000; rrotation=0.648, Protation=0.000), while negatively correlated with GRS, GLS and 3D-strain (rGRS=-0.680, PGRS=0.000; rGLS=-0.581, PGLS=0.000; r3D-strain=0.700, P3D-strain=0.000). Conclusion: The severer the severity of AS, the greater the damage to cardiac function. 3D-STI can assess the risk in the early stage, with good effect. |
Key words: Three-dimensional speckle tracking imaging Aortic stenosis Risk stratification |
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