自动心肌运动定量技术评价射血分数保留型频发室性早搏患者左室收缩功能的价值

doi:10.3969/j.issn.2095-9400.2021.04.004

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摘要目的：探讨自动心肌运动定量（aCMQ）技术评估射血分数保留型频发室性早搏患者左室收缩功能的价值。方法：选取34例射血分数保留型（LVEF＞50%）频发室性早搏患者作为室早组。同期选取性别匹配的27例健康者作为对照组。运用常规超声心动图获取2组左房内径（LAD）、左室舒张未内径（LVIDd）、左室收缩末内径（LVIDs）、左室射血分数（LVEF）、二尖瓣舒张早期和心房收缩期峰值流速比值（E/A）、二尖瓣舒张早期峰值流速与组织多普勒二尖瓣环（侧壁及室间隔）舒张早期速度平均值的比值（E/E’a）。运用aCMQ技术获得2组两腔心纵向应变（AP2LS）、三腔心纵向应变（AP3LS）、四腔心纵向应变（AP4LS）及整体纵向应变（LVGLS），左室短轴基底段环向应变（SAXBCS）、左室短轴中间段环向应变（SAXMCS）、左室短轴心尖段环向应变（SAXACS）及整体环向应变（LVGCS），并进行比较分析。结果：室早组与对照组年龄、体表面积差异无统计学意义（均P＞0.05）；室早组与对照组LVIDd、LVIDs差异均有统计学意义（均P＜0.05）；室早组与对照组LAD、LVEF、E/A、E/E’a差异无统计学意义（均P＞0.05）。室早组AP2LS、LVGLS、SAXMCS绝对值较对照组减低，差异有统计学意义（均P＜0.05）。AP2LS及LVGLS对频发室早患者左室收缩功能受损有较好的预测价值。结论：aCMQ技术能发现频发室早患者早期隐匿性的心功能改变，可作为一种评估左室收缩功能相对准确的方法。

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关键词 ：斑点追踪显像, 心室功能, 左, 频发室性早搏

Abstract：Objective: To explore the value of automated cardiac motion quantification (aCMQ) in evaluating left ventricular systolic function of frequent premature ventricular contractions (frequent PVCs) patients with ejection fraction preserved. Methods: From January 2018 to January 2019, 34 cases of frequent PVCs with ejection fraction preserved (LVEF>50%) were enrolled. At the same time, 27 healthy persons matched by sex were selected as the control group. The left atrial size (LAD), left ventricular end diastolic diameter (LVIDd), left ventricular end systolic diameter (LVIDs), left ventricular ejection fraction (LVEF) and diastolic function parameters (E/A and E/E’a, E’a referring to the average mitral annulus velocity of lateral and septal sides) were measured by conventional echocardiography. The main outcome assessments obtained by aCMQ technique were longitudinal strains of apex two-chamber view (AP2LS), apex three-chamber view (AP3LS), apex four-chamber view (AP4LS) and global longitudinal strain (LVGLS). Circumferential strains in three different levels of left ventricular in short axis, including basal level (SAXBCS), mid level (SAXMCS), apical level (SAXACS) and global circumferential strain (LVGCS) were also obtained. Results: There was no significant difference in age and body surface area between frequent PVCs group and control group (P>0.05). There was significant difference in LVIDd and LVIDs between the two groups (all P<0.05), but no significant difference in LAD, LVEF, E/A and E/E’a (all P>0.05). The absolute values of AP2LS, LVGLS and SAXMCS in frequent PVCs group were lower than those in the control group, showing significant differences (all P<0.05). ROC curve analysis showed AP2LS and LVGLS had a better predictive value for LV systolic dysfunction in frequent PVCs patients. Conclusion: ACMQ can detect the early subtle changes of cardiac function in frequent PVCs, and it can be used as a new method to detect the subtle LV dysfunction.

Key words： speckle tracking imaging ventricular function, left frequent premature ventricular contractions

收稿日期: 2020-05-16

基金资助:温州市科技计划项目（Y20170816）。

通讯作者: 吴道珠，副主任医师，Email：wdz6276@163.com。 E-mail: wdz6276@163.com

作者简介: 肖莉莉，主治医师，Email：danshui810@163.com。

链接本文:

https://xb.wmu.edu.cn/CN/10.3969/j.issn.2095-9400.2021.04.004 或 https://xb.wmu.edu.cn/CN/Y2021/V51/I4/276

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