Objective To assess the left ventricular function in patient with heart failure by using two-dimensional strain echocardiography( 2DSE ). Methods 2DSE was performed in 21 patients with heart failure( heart failure group )and 16 normal control subjects( control group )without coronary heart disease, cardiomyopathy, arrhythmia or any other cardiac disease. After conventional measurement, pictures from apical 4-chamber,3-chamber and 2-chamber view and mitral annulus, papillary and apex level short-axis view were collected. Global longitudinal peak systolic strain ( GLS ), global circumferential peak systolic strain ( GCS ), torsion ( ROT ), torsion rate ( ROTR ), global longitudinal systolic strain rate ( GSRs ), global early systolic strain rate ( GSRe ), global late systolic strain rate( GSRa ), GSRe/GSRa and T-Sre were measured and compared between the two groups by 2DSE. The conventional and 2DSE measured values were compared between the two groups,using a group design f-test. The correlation between LVEF and GLS or GCS were analyzed respectively. Results Conventional indicators ( LAD ^ LVDd ^ LVDs, LVEF, LVFS, E, A, EDT ) in the heart failure group were( 46. 38 ± 6. 42 )mm,( 68. 67 ± 8. 84 )mm,( 56. 24 ± 8.41 )mm,( 36. 81 ±4. 56 )% ,( 18. 47 ±2. 35 )% ,( 0. 06 ±0. 06 )m/s,( 0. 07 ±0. 04 )m/s,( 102. 29 ±32. 13 )ms;in the control group were( 30. 50 ±2. 78 )mm,( 45.06±2.57 )mm,( 29. 06 ±2. 21 )mm,( 65. 10 ±2. 66 )% ,( 35. 56 ± 1. 92 )% ,( 0. 76 ± 0.07 )m/s,( 0. 57 ± 0. 07 )m/s,( 178.69 ± 38. 16 )ms ,the differences had statistically significance between the two groups( t = - 9. 230, - 10. 324,12. 557, - 22. 064,-23.611, -42.996, -28.284, -6. 608,all P <0. 05 );2DS indicators( GLS,GCS, ROT,ROTR,GSRs, GSRe, GSRa, T-Sre )in the heart failure group were( - 7. 87 ± 3.79)%,( -7. 86 ±2. 77 )% , ( 4. 80 ±2. 19 )deg,( 37. 48 ± 11. 12 )deg/s, ( -0.42±0.26)s-1,(0.47±0.29)s-1,(0.30±0.20)s-(387.75±80.64)ms; in the control group were ( - 20. 52 ± 2. 67 )% , ( - 24. 63 ±5. 32 )% , ( 13.08 ±5. 82 )deg.( 109.13 ±24.31 )deg/s,( - 1.36 ±0.23 )s"1,( 1.53 ±0.29 )s"1, ( 0. 80 ± 0. 25 )s-1,( 321. 33 ±32. 63 )ms, the two groups had statistically difference (f = 11.348,12. 431, -6.008, -11.997,11.563, -10.968, -6.732,3. 099, all P<0.05). There were good correlations between GLS and GCS and LVEF( r =-0. 815 , -0. 864, P < 0. 05 ). Conclusion 2DSE can evaluate the left ventricular function with heart failure.%目的 探讨二维应变超声心动图评价心力衰竭患者左心室心肌收缩及舒张功能的价值.方法 选取心力衰竭患者21例(心力衰竭组),心功能正常,排除冠心病、心肌病、心律失常等其他心脏疾病的患者16例(对照组).对两组患者进行常规超声心动图测量,分别采集心尖长轴四腔切面、心尖长轴三腔切面、心尖长轴二腔切面,二尖瓣水平短轴切面、乳头肌水平短轴切面及心尖水平短轴切面的二维灰阶动态图.应用2DS软件测量并计算心力衰竭组及对照组左心室长轴整体收缩期最大峰值应变(GLS)、左心室轴向整体收缩期最大峰值应变(GCS)、左心室整体扭转度(ROT)、左心室整体扭转率(ROTR)、心脏整体收缩期应变率(GSRs)、舒张早期应变率(GSRe)、舒张晚期应变率(GSRa)、GSRe/GSRa及达舒张早期峰值应变率(SRe)时间(T-SRe).将心力衰竭组与对照组左心室常规及二维应变指标测值进行比较,采用成组计量资料的t检验,分析应变参数与左心室射血分数(LVEF)的相关性.结果 心力衰竭组的常规超声心动图指标LAD、LVDd、LVDs、LVEF、LVFS、E、A、EDT分别为(46.38±6.42)mm、(68.67±8.84)mm、(56.24±8.41)mm、(36.81±4.56)%、(18.47±2.35)%、(0.06±0.06)m/s、(0.07±0.04)m/s、(102.29±32.13)ms;对照组的分别为(30.50±2.78)mm、(45.06±2.57)mm、(29.06±2.21)mm、(65.10±2.66)%、(35.56±1.92)%、(0.76±0.07)m/s、(0.57±0.07)m/s、(178.69±38.16)ms,两组比较差异有统计学意义(t=-9.230、-10.324、12.557、-22.064、-23.611、-42.996、-28.284、-6.608,P均＜0.05);心力衰竭组患者常规超声心动图相关二维应变指标GLS、GCS、ROT、ROTR、GSRs、GSRe、GSRa、T-SRe分别为(-7.87±3.79)%、(-7.86±2.77)%、(4.80±2.19)deg、(37.48±11.12)deg/s、(-0.42±0.26)s-1、(0.47±0.29)s-1、(0.30±0.20)s-1、(387.75±80.64)ms,对照组的分别为(-20.52±2.67)%、(-24.63±5.32)%、(13.08±5.82)deg、(109.13±24.31)deg/s、(-1.36±0.23)s-1、(1.53±0.29)s-1、(0.80±0.25)s-1、(321.33±32.63)ms,两组比较差异均有统计学意义(t=11.348、12.431、-6.008、-11.997、11.563、-10.968、-6.732、3.099,P均＜0.05).GLS、GCS与LVEF之间有显著相关性(r=-0.815、-0.864,P均＜0.05).结论 二维应变超声技术对评价心力衰竭患者的左心室功能有很好的应用价值.
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