摘要
目的 探讨四维超声定量技术(4D LAQ)评价射血分数保留性心力衰竭(HFpEF)患者左房(IA)容积和应变功能变化的临床应用价值.方法 选取2021年1月～2022年6月于山东第二医科大学第一附属医院心内一科住院的50例HFpEF患者及同期30例健康体检者为研究对象.两组受试者应用常规超声心动图测量左室前后径、室间隔厚度、左室后壁厚度、左房前后径、左室射血分数(LVEF)、E峰、E'值、F/E'值;应用4D LAQ获取LA四维容积参数,如左房最小容积(LAVmin)、左房最大容积(LAVmax)、左房收缩前容积(LAVpreA)、左房每搏量(LAEV)和左房射血分数(LAEF),以及LA心肌应变参数,如左室收缩期、舒张早期和舒张晚期的LA心肌纵向应变值(LASr、LAScd和LASct)和圆周峰值应变参数(LASr_c、LAScd_c和LASct_c);比较两组受试者的上述参数.结果 与正常对照组相比,病例组LA四维容积参数LAVmin、LAVmax、LAVpreA及LAEV明显增加,LAEF值显著降低(P＜0.05);病例组 LA 应变参数 LAScd、LASct、LASr_c、LAScd_c 及 LASct_c 的绝对值增加,LASr 降低(P＜0.05);HFpEF 患者的LAVmin、LAVmax、LAVpreA、LAEV与E/E'值呈正相关(P＜0.05).结论 4D LAQ可以有效评估HFpEF患者LA容积和功能变化,对HF'pEF患者临床诊断、治疗和预后评估具有重要意义.
Abstract
Objective To evaluate the clinical value of the four-dimensional echocardiography on the changes of left atrial(LA)volume and strain function in patients with heart failure with ejection fraction preserved(HFpEF).Methods Fifty patients with HFpEF hos-pitalized in the Department of Cardiology Ⅰ of the First Affiliated Hospital of Shandong Second Medical University from January 2021 to June 2022.The control group consisted of 30 healthy subjects who visited our hospital during the same period.Both groups of subjects accepted conventional echocardiography to measure left ventricular end-diastolic dimension,interventricular septal thickness,left ventricular posterior wall thickness,left atrial diameter,left ventricular ejection fraction(LVEF),E velocity,E'velocity and E/E'ratio.Both groups of subjects ac-cepted four-dimensional left atrial quantification(4D LAQ)to obtain LA four-dimensional volume parameters,such as left atrial minimum vol-ume(LAVmin),left atrial maximum volume(LAVmax),left atrial pre-systolic volume(LAVpreA),left atrial ejection volume(LAEV)and left at-rial ejection fraction(LAEF),and to obtain LA strain parameters by 4D LAQ,such as LA longitudinal and circumferential strain during the left ventricular systole,the early diastole and late diastole,(LASr,LAScd,LASct,LASr_c,LAScd_c and LASct_c).Results Compared with the control group,LAVmin,LAVmax,LAVpreA and LAEV were all significantly increased in the case group,while the LAEF was significantly de-creased(P＜0.05).The absolute values of LAScd,LASct,LASr_c,LAScd_c and LASct_c were all significantly increased in the case group,while LASr was significantly decreased(P＜0.05).Correlation analysis showed that LAVmin,LAVmax,LAVpreA and LAEV were positively corre-lated with E/E'ratio in HFpEF patients(P＜0.05).Conclusion The four-dimensional echocardiography can effectively assess LA volume and functional changes in patients with HFpEF,which is important for clinical diagnosis,treatment and prognostic assessment.
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