纵向二维应变评价家族性高胆固醇血症患者左心室整体及局部收缩功能改变

摘要

目的 应用斑点追踪成像(STI)技术分析家族性高胆固醇血症(FH)患者左心室纵向应变,评价FH患者左心室整体及各段收缩功能.方法 对42例FH患者(FH组)及34名健康志愿者(正常对照组)行超声心动图检查,测量左心室各室壁基底段、中间段、心尖段共18个节段及整体收缩期峰值应变(S)、收缩期峰值应变率(SRs).结果 分析所有受检者共1368个节段,追踪成功率98.25％(1344/1368). FH组前壁基底段S较正常对照组减低(P＜0.05). FH组三腔心、两腔心、四腔心S、SRs均较正常对照组减低,但差异无统计学意义(P＞0.05) ;FH组整体SRs较正常对照组减低(P＜0.05).FH组后壁基底段、后间隔基底段及心尖段、侧壁基底段至中间段、下壁基底段至中间段及前壁基底段至中间段SRs较正常对照组减低(P＜0.05).结论 FH患者左心室整体及节段性收缩功能受损；通过STI技术纵向应变可早期发现其改变,其中SRs较S更敏感.%To evaluate the left ventricular systolic function of global and each section through left ventricular longitudinal strain in familial hypercholesterolemia (FH) patients with speckle tracking imaging (STI). Methods Forty-two patients with FH (FH group) and 34 volunteers (control group) underwent STI. The long axis myocardial peak systolic strain (S) and peak systolic strain rate (SRs) of 18 segments in different left ventricular walls and overall S and SRs were measured. Results Totally 1368 segments in 76 subjects were analyzed, and tracking successful rate was 98. 25% (1344/1368). The S of anterior basal segment in FH group decreased compared with that of control group (P<0.05). The three chambers,two chambers, four chambers of the heart S and SRs in FH group was lower than those of the control group, but the difference was not statistically significant (P>0.05). The overall SRs in the FH group decreased compared with that of control group (P<0.05). The SRs of posterior basal segment, poster-septal basal segment and the apex segment, lateral from basal segment to the middle segment, and anterior from basal segment to middle segment, inferior from basal segment to the middle segment in FH group were lower than those of the control group (P<0.05). Conclusion Using STI can detect left ventricular overall and segmental systolic function impairment in FH patients through longitudinal strain in the early stage. SRs is more sensitive than S.