| 李珺,杜国庆,王珍珍,李海茹,邓颖,田家玮.双多普勒同步成像技术评价高血压患者不同左心室构型的左心室舒张功能[J].中国医学影像技术,2016,32(5):732~736 |
| 双多普勒同步成像技术评价高血压患者不同左心室构型的左心室舒张功能 |
| Evaluation of left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns by dual-Doppler technology |
| 投稿时间：2015-08-24 修订日期：2015-10-26 |
| DOI：10.13929/j.1003-3289.2016.05.025 |
| 中文关键词: 超声心动描记术 双多普勒同步技术 高血压 心室功能,左 |
| 英文关键词:Echocardiography Dual-Doppler technology Hypertension Ventricular function, left |
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| 中文摘要: |
| 目的 探讨双多普勒同步成像技术评价高血压患者不同左心室构型左心室舒张功能的价值。方法 将179例高血压患者(高血压组)根据左心室心肌质量指数(LVMI)和相对室壁厚度(RWT)分为4亚组,即正常构型、向心重构型、离心肥厚型及向心肥厚型亚组;选取62名健康志愿者为对照组。随机选取73例患者,分别采用传统非同步模式和双多普勒同步模式测量相同参数,采用Bland-Altman法和组内相关系数(ICC)对两种模式行可重复性检验。采用双多普勒同步技术计算同一心动周期的二尖瓣口舒张早期峰值流速(E)和组织多普勒(TDI)二尖瓣环侧壁(L)二尖瓣环舒张早期峰值速度(e')的比值[E/e'(L)];同步计算二尖瓣口E峰和TDI二尖瓣环室间隔(S)舒张早期峰值速度(e')的比值[E/e'(S)];同步计算二尖瓣口E峰和舒张期二尖瓣口血流传播速度(Vp)的比值(E/Vp)。结果 高血压各亚组E/e'(S)、E/e'(L)、E/Vp均高于对照组(P均<0.05),向心肥厚亚组E/e'(S)、E/e'(L)、E/Vp分别高于正常构型亚组和向心重构亚组,余各组间比较差异无统计学意义,但正常构型亚组、向心重构亚组、离心肥厚亚组及向心肥厚亚组E/e'(S)、E/e'(L)、E/Vp均呈依次增高的趋势。Bland-Altman法显示双多普勒模式较非同步模式测量的E/e'(L)、E/e'(S)、E/Vp的可重复性更好,ICC值更高。结论 双多普勒同步成像技术较非同步模式重复性更好,可有效地评价高血压患者不同左心室构型的舒张功能受损情况。 |
| 英文摘要: |
| Objective To evaluate the value of left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns by dual-Doppler technology. Methods Totally 179 hypertensive patients (hypertension group) with four different ventricular configurations (normal geometry subgroup, concentric remodeling subgroup, eccentric hypertrophy subgroup and concentric hypertrophy subgroup) according to left ventricular mass index (LVMI) and left ventricular relative wall thickness (RWT) were recruited; 62 healthy volunteers were composed of the control group. All of 73 hypertensive patients were randomly selected. The same parameters were measured by the conventional Doppler modality and the dual-Doppler modality respectively. Repeatability test of the two modalities were performed by the Bland-Altman and intraclass correlation coefficient (ICC). The ratio of peak early diastolic transmitral flow velocity (E) and lateral (L) mitral annular early diastolic velocity (e'; E/e'[L]), the ratio of E and septal (S) mitral annular early diastolic velocity (e'; E/e'[S]), the ratio of peak early diastolic transmitral flow velocity (E) and color M-mode Doppler flow propagation velocity (Vp; E/Vp) were measured respectively by dual-Doppler technology. Results Compared with the control group, E/e' (L), E/e' (S) and E/Vp were higher in four hypertension subgroups (all P<0.05). The concentric hypertrophy subgroup was higher than that of the normal geometry subgroup and the concentric remodeling subgroup, respectively (P<0.05), the comparison among other groups had no statistical significance, but showed a stepwise increase from the normal geometry subgroup to the concentric remodeling subgroup, and then to the eccentric and concentric hypertrophy subgroup. The Bland-Altman showed that E/e' (L), E/e' (S) and E/Vp measured by the dual-Doppler modality had better reproducibility and higher ICC than those of the conventional modality. Conclusion The dual-Doppler technology has better reproducibility than the conventional Doppler modality, and is valuable for evaluating the left ventricular diastolic function in hypertensive patients with different left ventricular geometric patterns. |
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