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目的应用斑点追踪成像技术评价不同左心室构型原发性高血压患者左心室心肌纵向、径向及圆周方向收缩功能,并探讨其临床意义。方法选取原发性高血压患者150例和健康志愿者50例,应用斑点追踪成像技术测量左心室纵向、径向及圆周应变、应变率,并比较各组应变、应变率。结果离心性肥厚(E-LVH)组纵向、径向及圆周峰值应变、应变率均小于其他三组(P<0.05);向心性肥厚(C-LVH)组纵向、径向峰值应变、应变率小于正常构型(N-LV)组(P<0.05)和对照组(P<0.05);N-LV组纵向峰值应变、应变率小于对照组(P<0.05)。结论左心室心肌纵向应变是反映左心室收缩功能改变的灵敏指标,在高血压早期纵向应变减低时,径向和圆周应变共同维持正常LVEF;左心室心肌圆周应变是高血压左心室重构患者维持正常收缩功能的关键指标。
Objective To evaluate the longitudinal, radial and circumferential systolic function of left ventricular myocardium in patients with different left ventricular hypertensive patients by speckle tracking imaging and to explore its clinical significance. Methods 150 patients with essential hypertension and 50 healthy volunteers were selected. The longitudinal, radial and circumferential strain and strain rate of left ventricle were measured by speckle tracking imaging. The strain and strain rate of each group were compared. Results The longitudinal, radial and circumferential peak strain and strain rate in the group of eccentric hypertrophy (E-LVH) were less than those in the other three groups (P <0.05). The longitudinal and radial peak strain and strain rate (P <0.05) and control group (P <0.05). The longitudinal peak strain and strain rate in N-LV group were smaller than those in control group (P <0.05). Conclusion Longitudinal strain of left ventricular myocardium is a sensitive index to reflect the change of left ventricular systolic function. When longitudinal strain decreases in early stage of hypertension, radial and circumferential strain together maintain normal LVEF. Left ventricular circumferential strain is the maintenance of left ventricular remodeling in patients with hypertension The key indicator of normal systolic function.