| 王静,黄君红,谢明星,吕清,王新房,丁琳灵.左心房容积追踪技术评价2型糖尿病患者左心房功能[J].中国医学影像技术,2010,26(6):1065~1068 |
| 左心房容积追踪技术评价2型糖尿病患者左心房功能 |
| Assessment of left atrial function in type 2 diabetes mellitus patients with left atrial volume tracking technique |
| 投稿时间：2009-12-03 修订日期：2010-02-09 |
| DOI： |
| 中文关键词: 心房功能,左 糖尿病,2型 容积追踪 |
| 英文关键词:Atrial function, left Diabetes mellitus, type 2 Volume tracking |
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| 中文摘要: |
| 目的 探讨左心房容积追踪(LAVT)技术评价2型糖尿病(T2DM)患者左心房功能变化的临床价值。方法 T2DM患者31例(T2DM组),健康志愿者35名(对照组)。应用Hitachi EUB-6500超声诊断仪,获取动态心尖四腔、两腔心的二维灰阶图像储存。启动LAVT模式,分别在上述切面描记左心房内膜。系统自动获取左心房容积及容积-时间变化曲线。记录左心房最大容积(LAVmax)、左心房被动排空容积(LAVp)、左心房最小容积(LAVmin)及收缩期左心房充盈速率峰值(dV/dtS)、舒张早期左心房排出速率峰值(dV/dtE)及舒张晚期左心房排出速率峰值(dV/dtA)。所有容积指标均经体表面积(BSA)标化(LAVImax, LAVIp, LAVImin);计算左心房被动、主动及整体排空容积(LAVIpass、LAVIact、LAVItotal)及左心房被动排出率(%LAVIpass)、主动排出率(%LAVIact)、整体排出率(%LAVItotal)、有效左心房被动、主动排出率(%eLAVIpass、%eLAVIact)及左心房被动与主动排出量比值(LAVpass/act)。结果 ①与对照组相比,T2DM组LAr、A峰增加,E峰、E/A降低(P<0.05)。②左心房容积曲线图:对应心电图T波末首先出现一个向上的高峰(LAVmax)后,于心电图P波处出现一转折点(LAVp),接着出现向下的小波(LAVmin),左心房容积-时间曲线图则由一个向上的收缩期波(dV/dtS)以及舒张早期、晚期向下的两个波(dV/dtE、dV/dtA)组成。与对照组相比,T2DM组左心房容积曲线的各峰值降低,斜率相对更陡直;二者的容积-时间曲线走行基本一致。③与对照组相比,T2DM组LAVmax、LAVp、LAVmin、dV/dtA、LAVImax、LAVIp、LAVImin、LAVIact、%eLAVIact显著增加;%LAVIpass、%eLAVIpass则显著降低(P<0.05)。结论 T2DM患者早期心脏改变以舒张功能减退为主,左心房助力泵代偿收缩做功增加。LAVT技术能实时追踪T2DM患者的左心房容积变化,较准确评价左心房功能。 |
| 英文摘要: |
| Objective To explore the clinical value of left atrial volume tracking (LAVT) technique in assessment of the left atrial (LA) function in patients with type 2 diabetes mellitus (T2DM). Methods Totally 31 T2DM patients and 35 healthy subjects were enrolled in this study. LAVT technique was applied to display the LA volume and volume-time curve images on the apical two- and four-chamber views. The maximal LA volume at end-systole (LAVmax), LA volume at the onset of ECG-P wave (LAVp), and the minimal LA volume (LAVmin) from the LA volume curve were recorded. The systolic LA filling rate (dV/dtS), early and late diastolic LA emptying rates (dV/dtE and dV/dtA) were measured from the volume-time curve. Body surface area was used to revise these volume indexes (LAVImax, LAVIp, LAVImin). Then LA pass, act and total empting volume (LAVIpass, LAVIact, LAVItotal) and empting rate (%LAVIpass, %LAVIact, %LAVItotal), effective pass and act empting rate (%eLAVIpass, %eLAVIact), the proportionality of pass empting volume and act empting volume (LAVpass/act) were caculated. Results ①Compared with the healthy subjects, the value of LAr and Peak A increased, the value of peak E and E/A ratio decreased in T2DM patients (P<0.05). ②In the left atrial volume curve, there was an upward peak (LAVmax) just at the end of ECG-T wave, and then two little negative waves LAVp and LAVmin occurred after the ECG P-wave. In the left atrial volume-time curve, there was an upward systolic wave (dV/dtS) and two diastolic negative waves (dV/dtE, dV/dtA). Compared with the healthy subjects, every peak value in left atrial volume curve decreased in T2DM patients, and the slope became steeper; the patterns of left atrial volume-time curve were similar. ③LAVmax, LAVp, LAVmin, dV/dtA, LAVImax, LAVIp, LAVImin, LAVIact, %eLAVIact indices in T2DM patients were significantly higher than those of healthy subjects, whereas the %LAVIpass, %eLAVIpass indices were significantly lower than those of healthy subjects (P<0.05). Conclusion The major early cardiac change in T2DM patients is diastolic hypofunction combined with LA compensatory constriction increase. LAVT technique can implement the real-time tracing for changes of the left atrial volume in T2DM patients to accurately evaluate the LA function. |
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