左心房容积追踪技术在评价原发性高血压患者左心房功能变化中的应用价值

摘要

目的 探讨左心房容积追踪(LAVT)技术评价原发性高血压病(essential hypertension,EH)各发展阶段左心房功能变化的价值.方法 90例EH患者按Ganau左心室几何构型划分法分4组,对照组60例.LAVT技术构建双平面(bi-plane)左心房容积-时间曲线,获取左心房最大容积(LAVmax)、收缩期前容积(LAVp)及最小容积(LAVmin),计算左心房被动排空量(LAVpass)、主动排空量(LAVact)、总排空量(LAVtotal)及左心房被动排空率(LAVpass%)、主动排空率(LAVact %)、总排空率(LAVtotal %),由体表面积校正得左心房容积指数(LAVI).结果 EH各组与对照组比较LAVImax、LAVIp、LAVImin、LAVIact、LAVhotal均增大,LAVIpass%明显减小(P＜0.05),LAVIpass、LAVIact%、LAVhotal%差异无统计学意义(P＞0.05).EH患者LAVImax、LAVIp、LAVImin、LAVI total逐渐增大,LAVIpass%逐渐减小,而LAVIact在Ⅰ、Ⅱ、Ⅲ组逐渐增大,在Ⅳ组明显减小(P均＜0.01).结论 LAVT技术能准确、快捷地检测出EH患者左心室未发生重构时左心房功能的变化,是无创性评价EH进展过程中左心房功能的新方法.%Objective To assess the application value of alteration of left atrial function in patients with essential hypertension (EH) during different periods by left atrial volume tracking (LAVT) technique. Methods Based on Ganau method,90 patients were divided into 4 groups,60 healthy subjects were included as control. Left atrial volumetime curve of bi-plane was obtained by LAVT. The value of LA maximal volume(LAVmax), pre-systolic volume (LAVp), minimal volume (LAVmin) were measured on the curve, LA passive emptying volume(LAVpass), active emptying volume (LAVact), total emptying volume(LAVtotal), passive emptying fraction(LAVpass％ ),active emptying fraction(LAVact％ ), total emptying fraction ( LAVtotal％ ) were calculated. All LA volume measurements were corrected by body surface area into LA volume index(LAVI). Results Compared with the healthy group, LAVImax,LAVIp, LAVImin, LAVIact, LAVItotal increased, LAVIpass ％ decreased significantly in EH group (P＜ 0. 05). There were no significant differences in LAVIpass, LAVIact％, LAVItotal％ between healthy and EH groups (P＞ 0. 05).With the development of EH, LAVImax, LAVIp, LAVImin, LAVItotal increased but LAVIpass ％ decreased gradually in EH group, LAVIact increased gradually in Ⅰ , Ⅱ and Ⅲ group, then decreased significantly in Ⅳ group (P＜ 0. 01 ).Conclusions LA funtion can be evaluated accurately and rapidly using LAVT technique in early-state in patients with EH. It is a promising noninvasive method for evaluating LA function in the patients with EH during LV geometric remodeling.