应用Auto Strain定量技术评价慢性血栓栓塞性肺动脉高压患者的左心功能
Application of Auto Strain to Evaluate Left Heart Function in Patients with Chronic Thromboembolic Pulmonary Hypertension
王丽红 1荆艳艳 2高婷 1许晓敏 3吴慧慧 1毛宏月 1李宛宴1
作者信息
- 1. 烟台毓璜顶医院超声科 山东省烟台市,264000
- 2. 烟台毓璜顶医院心内科 山东省烟台市,264000
- 3. 滨州医学院 山东省烟台市,264000
- 折叠
摘要
目的 应用自动应变(Auto Strain)定量技术评价慢性血栓栓塞性肺动脉高压(CTEPH)患者左心功能变化,并探讨影响CTEPH患者生存的左心应变参数.方法 回顾性分析确诊的CTEPH患者30例,全因死亡为复合终点,选取同期性别、年龄相匹配的健康体检者30例为对照组,获取所有受试者的左心常规参数和左右心应变参数.CTEPH组进行右心导管插入术(RHC),以肺动脉平均压(mPAP)45 mmHg为界将CTEPH组分为中度、重度PH组,比较各组间参数差异,应用回归分析确定影响CTEPH患者生存的应变参数.结果 ①与对照组相比,CTEPH组的左心房最大容积指数(LAVI)、二尖瓣舒张早期峰值流速与室间隔、侧壁二尖瓣环舒张早期峰值速度之比的平均值(E/e')增大,左心室舒张末期容积(LVEDV)减小(P＜0.05),右心室游离壁纵向应变(RVFWLS)、左心房储存期峰值应变(LASr)、管道期峰值应变(LAScd)、收缩期峰值应变(LASct)、左心室整体纵向应变(LVGLS)的绝对值均减低(P＜0.05).②与对照组相比,中度、重度PH组的LAVI、E/e'均增大,LVEDV和RVFWLS的绝对值均减小(P＜0.05),重度PH组L Asr、L Ascd、L Asct、LVGLS的绝对值均减低(P＜0.05).与中度PH组相比,重度PH组Mpap、肺血管阻力(PVR)增大,LAVI、E/e'增大,LVEDV 减小(P＜0.05),RVFWLS、LASr、LAScd、LASct、LVGLS 的绝对值均减低(P＜0.05).③ Logistic 回归分析显示,L Asct、LVGLS是CTEPH患者生存的预测因子(P＜0.05).结论 Auto Strain能够较早识别CTEPH患者左心功能减低,LASct、LVGLS是影响CTEPH患者生存的功能指标.
Abstract
Objective To explore the application value of Auto Strain technique in evaluating changes of left heart function in patients with chronic thromboembolic pulmonary hypertension(CTEPH)and to find which left heart strain parameters could affect the survival of CTEPH patients.Methods We retrospectively analyzed 30 patients with CTEPH diagnosed,with all-cause death as the composite endpoints.Selected 30 health checkups matched by sex and age in the same period as the control group,and obtained the left heart routine parameters and left and right heart strain parameters of all the subjects.Right heart catheterization(RHC)was performed in the CTEPH group,and the CTEPH group was divided into moderate and severe PH groups by using the 45 mmHg of mean pulmonary artery pressure(mPAP)as a cut-off value.The differences of parameters between the groups were compared,and regression analysis was applied to determine the strain parameters which affecting the survival of CTEPH patients.Results① Compared with the control group,the CTEPH group showed an increase in left atrial maximum volume index(LAVI),the average ratio of early diastolic velocity of the mitral valve to early diastolic velocity of the mitral annulus on the interventricular septum and lateral wall(E/e'),a decrease in left ventricular end-diastolic volume(LVEDV)(P＜0.05),and a decrease in the absolute values of right ventricular free wall longitudinal strain(RVFWLS),left atrial reservoir strain(LASr),left atrial conduit strain(LAScd),left atrial contraction strain(LASct)and left ven-tricular global longitudinal strain(LVGLS)(P＜0.05).② Compared with the control group,LAVI、E/e'increased and LVEDV、the absolute values of RVFWLS decreased in both moderate and severe PH groups(P＜0.05),and the absolute values of LASr,LAScd,LASct,and LVGLS were all reduced in the severe PH group,and the differences were all statistically significant(P＜0.05).Compared with the moderate PH group,mPAP and pulmonary vascular resistance(PVR)increased,LAVI、E/e'increased,LVEDV decreased in the severe PH group(P＜0.05),and the absolute values of RVFWLS,LASr,LAScd,LASct,and LVGLS were all diminished(P＜0.05).③ Logistic regression analysis showed that LASct and LVGLS were predictors of survival in CTEPH patients(P＜0.05).Conclusions Auto Strain is able to recognize the reduced left heart function of CTEPH patients earlier,and LASct and LVGLS are functional indicators affecting the survival of CTEPH.
关键词
超声心动图/自动应变/左心功能/慢性血栓栓塞性肺动脉高压Key words
Echocardiography/Auto Strain/Left heart function/Chronic thromboembolic pulmonary hyper-tension引用本文复制引用
出版年
2025
NETL
NSTL
万方数据