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目的探讨高血压患者左右室心肌应变特征。方法70例原发性高血压患者及30例正常人,行常规超声心动图检查并测量左房、左室大小,室间隔、左室后壁及右室前壁厚度,室间隔增厚率和射血分数。同时测定舒张早期左室充盈峰速度(E)、心房收缩期左室充盈峰速度(A)、E/A比值等参数。依据室间隔及左室后壁厚度将70例原发性高血压患者分为两组:左室肥厚组(LVH)30例,室间隔及左室后壁厚度≥12mm;无左室肥厚组(NLVH)40例,室间隔及左室后壁厚度<12mm。心尖两腔、三腔和四腔切面获得组织速度成像(TVI)图像,应用应变率成像技术分析左室和右室游离壁基底及中间部各节段心肌的应变率曲线,并计算应变率值。结果与对照组及NLVH组相比,LVH组收缩期峰值应变率(SRs)、舒张早期峰值应变率(SRe)及心房收缩期应变率峰值(SRa)均降低(P<0.05)。结论应变率成像可评价不同程度原发性高血压患者的心室收缩及舒张功能。
Objective To investigate the myocardial strain characteristics of left and right ventricular hypertensive patients. Methods Seventy patients with essential hypertension and 30 normal subjects were examined by routine echocardiography and measured left atrium, left ventricular size, interventricular septum, left ventricular posterior wall and right ventricular anterior wall thickness, ventricular septal thickening rate and Ejection fraction. The parameters of left ventricular filling peak velocity (E), left ventricular filling peak velocity (A) and E / A ratio during early diastole were measured. Seventy patients with essential hypertension were divided into two groups according to the interventricular septum and left ventricular posterior wall thickness: left ventricular hypertrophy group (LVH) 30 cases, interventricular septum and left ventricular posterior wall thickness≥12mm, without left ventricular hypertrophy group NLVH) 40 cases, ventricular septum and left ventricular posterior wall thickness <12mm. Tissue velocity imaging (TVI) images were obtained from apical two, three and four chamber sections. Strain rate curves were calculated using strain rate imaging technique in the basal and middle segments of left and right ventricular free wall. . Results Compared with control group and NLVH group, peak systolic strain (SRs), early diastolic peak strain (SRe) and atrial systolic strain peak (SRa) were significantly decreased in LVH group (P <0.05). Conclusion Strain rate imaging can assess ventricular systolic and diastolic function in patients with different degrees of essential hypertension.