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目的探讨三维斑点追踪技术在评价主动脉瓣反流(aortic regurgitation,AR)患者亚临床左心室心肌损伤中的价值。方法左室射血分数正常AR患者71例,其中轻度反流31例,中度反流21例,重度反流19例;同期30例体检健康者为对照组。各组均应用三维斑点追踪技术行超声心动图检查,测量左心室三维整体纵向应变(three-dimensional global longitudinal strain,3D-GLS)、三维整体径向应变(three-dimensional global radial strain,3D-GRS)、三维整体面积应变(three-dimensional global area strain,3D-GAS)及三维整体圆周应变(three-dimensional global circumferential strain,3D-GCS),并进行比较。结果轻度反流组|3D-GLS|[(18.6±2.8)%]、|3D-GAS|[(30.6±4.7)%]、|3D-GCS|[(18.6±3.1)%]以及3D-GRS[(38.1±6.2)%]与对照组[(19.1±3.3)%、(30.1±5.7)%、(19.2±5.3)%、(40.1±6.3)%]比较差异无统计学意义(P>0.05);中度反流组|3D-GLS|[(17.1±3.1)%]、|3D-GAS|[(26.1±4.1)%]低于对照组(P<0.05);重度反流组|3D-GLS|[(14.2±3.2)%]、|3D-GAS|[(20.1±3.9)%]、|3D-GCS|[(15.7±4.0)%]、3D-GRS[(33.4±6.2)%]均低于对照组,|3D-GLS|、|3D-GAS|低于中度反流组(P<0.05)。结论左室射血分数正常中、重度AR患者左心室已出现亚临床心肌损伤,三维斑点追踪技术可用于评估AR患者左心室亚临床心肌损伤。
Objective To investigate the value of three-dimensional speckle tracking in subclinical left ventricular myocardial injury in patients with aortic regurgitation (AR). Methods Totally 71 patients with normal left ventricular ejection fraction were enrolled in this study. There were 31 mild reflux, 21 moderate reflux and 19 severe reflux; Three groups of three-dimensional global longitudinal strain (3D-GLS) and three-dimensional global radial strain (3D-GRS) were measured by echocardiography. ), Three-dimensional global area strain (3D-GAS) and three-dimensional global circumferential strain (3D-GCS) were calculated and compared. RESULTS: The mild regurgitation group had a significantly higher rate of 3D-GLS and 3D-GLS compared with 3D-GLS, There was no significant difference in GRS [(38.1 ± 6.2)%] compared with control group [(19.1 ± 3.3)%, (30.1 ± 5.7)%, (19.2 ± 5.3)% and (40.1 ± 6.3)%, respectively (P <0.05); moderate reflux group | 3D-GLS | [(17.1 ± 3.1)%], | 3D-GAS | | 3D-GAS | [(20.1 ± 3.9)%], | 3D-GCS | [(15.7 ± 4.0)%], 3D-GRS [(33.4 ± 6.2) %] Were lower than that of the control group, | 3D-GLS |, | 3D-GAS | sub-moderate reflux group (P <0.05). Conclusion Subclinical myocardial injury has appeared in the left ventricle of patients with moderate or severe left ventricular ejection fraction. The three-dimensional speckle tracking technique can be used to evaluate the left ventricular subclinical myocardial injury in patients with AR.