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目的应用全方向M型超声心动图来评价高血压局部心肌运动功能的变化。方法正常健康志愿者32例,高血压左心室肥厚(LVH)患者32例。应用全方向M型超声心动图系统分别测量左心室短轴3个水平(二尖瓣水平、乳头肌水平、心尖水平)各节段室壁收缩期及舒张期内膜速度(Ven)、外膜速度(Vep)、速度差(ΔV)及室壁厚度(D),计算心肌速度梯度(MVG)=(Ven-Vep)/D,将两组3个水平各相应节段测得的MVG进行对比分析,应用二维应变技术测量正常组左心室短轴二尖瓣水平各节段心肌应变率(SR),并与全方向M型超声心动图测得的相应节段MVG进行相关分析。结果 LVH组于左心室短轴切面3个水平发生心肌肥厚的室间隔节段其收缩、舒张期的MVG低于正常组(P<0.05),而无肥厚的下壁其收缩、舒张期的MVG也低于正常组(P<0.05),相关分析结果显示两种技术相关性良好。结论全方向M型超声心动图能用于定量评价局部心肌运动功能的变化,高血压左心室肥厚患者在整体收缩及舒张功能在正常范围时就可出现局部心肌运动功能异常。
Objective To evaluate the changes of local myocardial function in hypertension using omni-directional M-mode echocardiography. Methods 32 healthy volunteers and 32 hypertensive patients with left ventricular hypertrophy (LVH). All-directional M-mode echocardiography was used to measure the ventricular wall systolic and diastolic velocities at three levels of left ventricular short axis (mitral level, papillary muscle level and apical level) MVG = (Ven-Vep) / D was calculated and compared between the two groups at each of the three levels of MVG The strain rate (SR) in each segment of the left ventricular short axis at the mitral valve level was measured by two-dimensional strain technique. The correlation analysis was performed with the corresponding segment MVG measured by omni-directional M-mode echocardiography. Results Compared with the normal group, MVH in LVH group was significantly lower than that in the normal group (P <0.05), while LVH group had no systolic and diastolic MVG Also lower than the normal group (P <0.05), the correlation analysis showed good correlation between the two technologies. CONCLUSION: Omnidirectional M-mode echocardiography can be used to quantitatively evaluate the changes of local myocardial motor function. Local hypertensive left ventricular hypertrophy may show abnormal myocardial function when the general contractile and diastolic functions are in the normal range.