王金锐,那日苏,秦林金,刘志耀,刘国辉,王淑敏,杨敬英.室壁应力与应变的关系评价高血压病左室收缩功能[J].中国医学影像技术,2003,19(12):1646~1649
室壁应力与应变的关系评价高血压病左室收缩功能
]Relationship between Left Ventricular Wall Stress and Strain:Evaluating Left Vertrical Systolic Function in the Patients with Hypertension
投稿时间:2003-10-20  
DOI:
中文关键词:  超声心动图  应力  应变  高血压  左室功能
英文关键词:Echocardiography  Stress  Strain  Hypertension  Left ventricular function
基金项目:本课题受内蒙古科学技术委员会和内蒙古卫生厅资助(20001306)。
作者单位
王金锐 北京大学第三医院超声科,北京 100083 
那日苏 内蒙古医学院病理教研室 
秦林金 内蒙古医学院病理教研室 
刘志耀 内蒙古医学院病理教研室 
刘国辉 内蒙古超声影像研究所 
王淑敏 内蒙古超声影像研究所 
杨敬英 内蒙古超声影像研究所 
摘要点击次数: 2716
全文下载次数: 2328
中文摘要:
      目的 探索用室壁应力(stress)与应变(strain)的关系评价高血压病左室收缩功能的临床价值。方法 研究对象为55例高血压病患者和30例健康人。应用超声心动图计算左室射血分数(EF)、心指数(CI)、重量指数(LVMI)和相对室壁厚度(RWT),并联合袖带肱动脉血压值计算左心室收缩期室壁经线峰值应力(Pσm)。根据LVMI和RWT将高血压病分为左室正常构型和左室重构两组。在数字化超声工作站中应用定量组织速度成像(QTVI)获取左室前壁心肌2个节段长轴应变曲线和峰值收缩应变值(PSS)。结果 ①以EF,CI表示的心脏收缩功能,在高血压病左室正常构型组值中无明显变化;而在高血压病左室重构组中下降,差异具有极显著意义(P<0.01)。②Pσm在高血压病两组中较对照组均有增高(P<0.05~0.01),两组间比较差异具有极显著意义(P<0.01)。③高血压病两组左室前壁基底段(Bas)和中段(Mid)的pSS值均显著下降(P<0.01),两组间比较差异具有极显著意义(P<0.01)。④直线相关分析结果显示高血压病两组Pσm与PSSBas和PSSMid均呈显著负相关。根据正常构型组Pσm与PSSBas直线回归方程计算,在相同Pσm水平,左室重构组PSSBas的实测值显著低于预测值及实测值与预测值的比值较正常构型组显著下降,差异具有极显著意义(P<0.01)。结论 ①心脏室壁应力与应变的关系不依赖于心脏后负荷。②用心脏室壁应力与应变的关系评价高血压病左室收缩功能,能够更客观反映心肌本身的生物力学特性,可能成为评价在体心脏心肌病理生理改变的有价值方法。
英文摘要:
      Objective To explore the relationship between the left ventricular(LV)wall stress and strain for evaluating the clinical significance of LV systolic function in the patients with hypertension.Methods The left ventricular mass index (LVMI), relative wall thickness (RWT), ejection fraction (EF) and cardiac index (CI) were evaluated by echocardiography in 55 cases with essential hypertension and 30 normal control subjects. LV wall meridional peak systolic stress (Pσm) was calculated by brachial blood pressure. Patients with hypertension were divided into patterns of normal geometric LV and remodeling LV according to LVMI and RWT. Quantitative tissue velocity imaging (QTVI) was applied for obtaining the basal and middle segments of LV anterior wall long axis strain curve and peak systolic strain. Results ①The LV systolic function was decreased (EF and CI) in hypertension with remodeling LV group (P<0.01), but no significant change in hypertension with normal geomertric LV group. ②Pσm was higher in two hypertension groups than in the control group (P<0.05-0.01), and it had significant difference between two hypertension groups (P<0.01). ③The PSS of the basal and middle segments in LV anterior wall was lower in two hypertension groups than in the control group (P<0.01), and it had significant difference between two hypertension groups (P<0.01). ④There is remarkably negative correlation between Pσm and PSS(Bas and Mid). To calculate the Pσm and PSSBas in the normal geometric group according to the regression equation at the same stress level, the result was that the real measured value of the PSSBas significantly lower than the estimated value of the PSSBas and the ratio of the real measured value and the estimated value of the PSSBas in remodeling geometric group decreased significantly than in normal geometric group (P<0.01). Conclusion ①The relationship of LV wall stress and strain was independent on the after load of the heart. ②To evaluate the myocardial contractility by applying the relationship of LV wall stress and strain is able to reflect biomechanical character of myocardium more objectively, and it may be a useful method in evaluating the pathophysiological changes of myocardium in vivo.
查看全文  查看/发表评论  下载PDF阅读器