谢林,吴凌恒,陈建雄,孙佳丽,陆敏,胡浩清,杜联芳,李朝军.左心室心肌应变参数预测初诊及未经治疗高血压患者射血分数保留性心力衰竭[J].中国医学影像技术,2023,39(10):1502~1507
左心室心肌应变参数预测初诊及未经治疗高血压患者射血分数保留性心力衰竭
Left ventricular myocardial strain parameters for predicting heart failure with preserved ejection fraction in newly diagnosed or untreated hypertension patients
投稿时间:2023-06-18  修订日期:2023-08-10
DOI:10.13929/j.issn.1003-3289.2023.10.013
中文关键词:  高血压  心力衰竭,舒张期  应变  超声心动描记术
英文关键词:hypertension  heart failure, diastolic  strain  echocardiography
基金项目:上海市科技计划项目(21ZR1451400)、上海市卫生健康委员会科研项目(202240235)。
作者单位E-mail
谢林 嘉定区中医医院超声科, 上海 201800
上海市第一人民医院嘉定分院超声科, 上海 201803 
 
吴凌恒 福建医科大学附属闽东医院超声科, 福建 宁德 355000  
陈建雄 福建医科大学附属闽东医院超声科, 福建 宁德 355000  
孙佳丽 上海市第一人民医院嘉定分院超声科, 上海 201803  
陆敏 嘉定区中心医院超声科, 上海 201800  
胡浩清 嘉定区中医医院超声科, 上海 201800  
杜联芳 上海交通大学医学院附属第一人民医院超声医学科, 上海 200080  
李朝军 上海市第一人民医院嘉定分院超声科, 上海 201803
上海交通大学医学院附属第一人民医院超声医学科, 上海 200080 
lzj_1975@sina.com 
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中文摘要:
      目的 观察左心室心肌应变参数用于预测初诊及未经治疗高血压患者射血分数保留性心力衰竭(HFpEF)的价值。方法 纳入105例初诊或未经治疗原发性高血压伴HFpEF患者(HFpEF组)和131名健康志愿者(对照组),比较组间左心室结构、功能和心肌应变参数,包括舒张末期左心室内径(LVEDD)、收缩末期左心室内径(LVESD)、舒张末期室间隔厚度(IVSD)、舒张末期左心室后壁厚度(LVPWD)、左心室射血分数(LVEF)、二尖瓣口舒张早期血流峰值速度(E)、二尖瓣口舒张晚期血流峰值速度(A)、二尖瓣环室间隔侧舒张早期峰值速度(e')、整体纵向应变(GLS)及整体圆周应变(GCS);以相关性分析及logistic回归分析观察HFpEF的影响因素。结果 组间LVEDD、IVSD、LVPWD、LVEF、GLS及GCS差异均有统计学意义(P均<0.05)。HFpEF组GLS与E、E/A、LVEF呈负相关(r=-0.287、-0.207、-0.449,P均<0.01),与年龄、LVESD呈正相关(r=0.149、0.178,P均<0.05);GCS与CAPP、IVSD、E、LVEF呈负相关(r=-0.169、-0.189、-0.219、-0.604,P均<0.05),与LVESD呈正相关(r=0.208,P<0.01)。高血压和GCS均为HFpEF的独立危险因素(P均<0.05),CAPP、IVSD和LVPWD均为独立保护因素(P均<0.05)。结论 初诊及未经治疗高血压患者左心室GCS有助于预测HFpEF,而GLS与HFpEF无明显相关性。
英文摘要:
      Objective To observe the value of left ventricular myocardial strain parameters for predicting heart failure with preserved ejection fraction (HFpEF) in newly diagnosed or untreated hypertension (HP) patients. Methods Totally 105 newly diagnosed or untreated primary HP patients with HFpEF (HFpEF group) and 131 healthy volunteers (control group) were enrolled. The left ventricular structure, function and myocardial strain parameters, including left ventricular end-diastolic diameter (LVEDD), left ventricular end-systolic diameter (LVESD), interventricular septal thickness at end-diastole (IVSD), left ventricular posterior wall thickness at end-diastole (LVPWD), left ventricular ejection fraction (LVEF), mitral valve peak velocity of early (E) and late (A) diastolic flow, early diastolic velocity of the septal mitral annulus (e'), left ventricular global longitudinal strain (GLS) and left ventricular global circumferential strain (GCS) were measured and compared between groups. Correlation analysis and logistic regression analysis were performed to screen the impact factors of HFpEF. Results Significant differences of LVEDD, IVSD, LVPWD, LVEF, GLS and GCS were found between groups (all P<0.05). In HFpEF group, GLS was negatively correlated with E, E/A and LVEF (r=-0.287, -0.207, -0.449, all P<0.01) but positively correlated with age and LVESD (r=0.149, 0.178, both P<0.05), while GCS was negatively correlated with CAPP, IVSD, E and LVEF (r=-0.169, -0.189, -0.219, -0.604, all P<0.05) but positively correlated with LVESD (r=0.208, P<0.01). HP and GCS were both independent risk factors (both P<0.05), while CAPP, IVSD and LVPWD were all independent protective factors of HFpEF (all P<0.05). Conclusion In newly diagnosed or untreated HP patients, left ventricular GCS was helpful for predicting HFpEF, while GLS was not obviously correlated with HFpEF.
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