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目的探讨超声应变率成像(SRI)技术在评价绝经早期女性左室舒缩功能方面的可行性。方法随机选取天津中医药大学第二附属医院门诊及住院患者中年龄相匹配的受试者96例,其中包括围绝经期女性45例和绝经早期女性51例。通过定量组织速度成像技术(QTVI)获取图像,应用SRI技术测量心尖四腔切面、心尖两腔切面的左室壁基底段心肌收缩期、舒张早期和舒张晚期的峰值应变率(分别缩写为SRs、SRe和SRa),并计算平均峰值应变率(m SR)。常规超声心动图测量左室射血分数(LVEF)、二尖瓣口舒张早期和晚期峰值流速(分别为E、A),并计算E/A。结果与围绝经期组相比,绝经早期组左室m SRs降低,且m SRs与LVEF呈显著负相关(r=-0.71,P<0.01);绝经早期组二尖瓣口E峰峰值流速、E/A降低,m SRe、m SRe/m SRa降低,且m SRe/m SRa与E/A呈良好正相关(r=0.67,P<0.01)。结论 SRI技术能快速、无创地定量评价绝经女性左室心肌收缩及舒张功能改变,尤其是早期存在的功能障碍,这为女性健康保健提供更为客观的理论依据。
Objective To investigate the feasibility of ultrasound strain rate imaging (SRI) in assessing left ventricular systolic and diastolic function in early menopausal women. Methods A total of 96 age-matched outpatients and inpatients from the Second Affiliated Hospital of Tianjin University of Traditional Chinese Medicine were selected, including 45 perimenopausal women and 51 premenopausal women. Images were acquired by Quantitative Tissue Velocity Imaging (QTVI). SRI was used to measure the peak systolic velocity at the apical four-chamber view, the left ventricular wall at the apical two-chamber view, and the peak strain rates at the early diastole and the late diastole (SRs, SRe and SRa) and calculate the average peak strain rate (m SR). Conventional echocardiography was used to measure left ventricular ejection fraction (LVEF), mitral early diastolic and late peak velocities (E, A, respectively), and E / A was calculated. Results Compared with the perimenopausal group, the left ventricular m SRs decreased in the early menopausal group and the m SRs was significantly negatively correlated with the LVEF (r = -0.71, P <0.01). In the early menopause group, the mitral valve peak E velocity, E / A decreased, m SRe, m SRe / m SRa decreased, and m SRe / m SRa had positive correlation with E / A (r = 0.67, P <0.01). Conclusion SRI can rapidly and noninvasively quantify the changes of left ventricular systolic and diastolic function in postmenopausal women, especially the early dysfunction. This provides a more objective theoretical basis for female health care.