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自动功能成像在原发性高血压左室纵向收缩功能中的价值
李娜,谯朗,马蓉,熊开玲,何俊璇,汪洋
0
(四川省中西医结合医院功能科;四川省中西医结合医院心内科)
摘要:
目的 探讨实时三切面自动功能成像(AFI)在评价原发性高血压患者心脏左室心肌纵向收缩功能中的价值。方法 选择2016年5月~2017年5月不伴左心室肥厚的原发性高血压患者60例(B组)及伴有左心室肥厚的高血压患者60例(C组)和健康体检者60例(A组)为研究对象,分别获取左室心尖实时三平面二维动态灰阶图像并存储,应用AFI软件检测得到左室17节段的整体收缩期纵向应变值(GLS)及局部收缩期峰值应变值(RLS),对获取的相应数据进行两两比较并分析。结果 ①B组及C组高血压患者在不同水平-基底段、中间段及心尖段的局部峰值应变值较A组健康人低,差异有统计学意义(P<0.05);C组在基底段、中间段的局部峰值应变值较B组低,差异有统计学意义(P<0.05),②B组的整体峰值应变值在LAX及2C两个切面均较A组低,差异有统计学意义(P<0.05);C组的整体平均峰值应变值(AVg)较B组低,差异有统计学意义(P<0.05)。③B组在所有不同节段收缩期局部峰值应变值较A组低,差异有统计学意义(P<0.05),C组在不同节段仅前壁及后壁收缩期局部峰值应变较B组低,差异有统计学意义(P<0.05)。④高血压B组及C组在部分不同节段的ROC曲线下面积比较,差异有统计学意义(P<0.05)。结论〓原发性高血压患者在早期左室收缩功能正常,构型未发生改变时,心肌即可出现整体及局部应变减低;在构型发生改变后与构型未发生改变时,心肌整体及局部应变值的变化比较,差异无统计学意义。AFI技术可早期准确地定量评估原发性高血压患者早期左室心肌的整体及局部纵向收缩功能改变。
关键词:  原发性高血压  实时三平面  自动功能成像  左心室收缩功能  纵向应变
DOI:
基金项目:四川省卫计委科研课题(16PJ505)
Study on the value of automatic functional imaging in left ventricular longitudinal contraction of essential hypertension
LI Na,QIAO lang,MA Rong,XIONG Kailing,HE Junxuan,WANG Yang
(Department Function, Sichuan Integrative Medicine Hospital;Department of Cardiology, Sichuan Integrative Medicine Hospital)
Abstract:
Objective To investigate the value of realtime threesection autoimaging AFI in the evaluation of longitudinal systolic function in patients with essential hypertension. Methods 60 patients with essential hypertension without left ventricular hypertrophy from May 2016 to May 2017 (group B), 60 patients with left ventricular hypertrophy (group C) and 60 healthy persons (group A) were selected in the present study. The realtime threeplane twodimensional dynamic grayscale images of left ventricular apex were recorded. The AFI software was used to detect the global systolic longitudinal strain (GLS) and local systolic peak strain (RLS) in 17 segments of the left ventricle, and the corresponding data were compared and analyzed. ResultsThe local peak strain of hypertension patients in group B and group C at different levelsbasal, middle and apical segments was lower than that of healthy group A (P<0.05). The local peak strain in the basal segment and the middle segment was lower than that in the B group (P<0.05). The whole peak strain value in both LAX and 2C in group B was lower than in that in group A (P<0.05). The overall average peak strain AVg in group C was lower than that in group B. (P<0.05). The local peak strain in group B was lower than that in group A at the systolic phase in all segments (P<0.05). In group C, the local peak strain in the systolic phase of the anterior and posterior wall was lower than that of B in different segments.Conclusion When the left ventricular systolic function is normal in patients with essential hypertension, and the configuration did not change, the whole and local strains of the heart muscle could be reduced. Changes in global and local strain values are not statistically significant, when the configuration is changed and when the configuration is not changed. AFI technology can accurately and quantitatively assess the early and overall longitudinal systolic function changes of left ventricular myocardium in patients with essential hypertension.
Key words:  Essential hypertension  Real-time triplane  Automatic functional imaging  Left ventricular systolic function  Longitudinal strain

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