心肌分层应变评估重度主动脉瓣狭窄患者左室心肌收缩功能变化

Abstract
Figure/Table
References (0)
Related Citation (15)

Download: PDF (1430 KB) HTML (1 KB)
Export: BibTeX | EndNote (RIS)

Abstract Objective: To quantitatively evaluate left ventricular (LV) systolic function in severe aortic stenosis (AS) with normal left ventricular ejection fraction (LVEF) using layer-specific strain (LSS). Methods: Fifty-seven patients with severe AS (including 36 cases with LV wall thickness and 21 cases with normal wall thickness, all patients had LVEF≥55%) and 30 controls from January 2012 to September 2017 in Huangyan Hospital of Wenzhou Medical University were included in this study. The global endocardial (Endo), mid-wall (Mid), epicardial (Epi) longitudinal peak strain (GLS) and circumferential peak stain (GCS) were analyzed. The repeatability of GLS and GCS was evaluated in 20 cases randomly selected from the investigated subjects as the AS and controls. Results: Endo-GLS, Mid-GLS, Epi-GLS in AS with and without wall thickness were significantly reduced compared with the controls (P<0.05); and Endo-GLS, Mid-GLS, Epi-GLS in AS with wall thickness were statistically lower than that with LV normal wall thickness (P<0.05). There was no significant difference in Endo-GCS, Mid-GCS, Epi-GCS between the above three groups (P>0.05). Conclusion: With the increase of LV wall thickness, Endo-GLS, Mid-GLS, Epi-GLS gradually decrease in the AS patients. Endo-GLS, Mid-GLS, Epi-GLS can be used to identify subtle contractile dysfunction triggered by increased LV wall thickness in severe AS with normal LVEF.

Key words： layer-specific strain aortic valve stenosis ventricular function, left echocardiography

Received: 08 November 2017

	Service
	E-mail this article
	Add to my bookshelf
	Add to citation manager
	E-mail Alert
	RSS
	Articles by authors
	LIN Jie
	YAN Zhihan

URL:

https://xb.wmu.edu.cn/EN/ OR https://xb.wmu.edu.cn/EN/Y2018/V48/I4/289

[1] DWECK M R, BOON N A, NEWBY D E. Calcific aortic stenosis: a disease of the valve and the myocardium[J]. J Am Coll Cardiol, 2012, 60(19): 1854-1863.
[2] CARASSO S, MUTLAK D, LESSICK J, et al. Symptoms in severe aortic stenosis are associated with decreased compensatory circumferential myocardial mechanics[J]. J Am Soc Echocardiogr, 2015, 28(2): 218-225.
[3] KAMPERIDIS V, JOYCE E, DEBONNAIRE P, et al. Left ventricular functional recovery and remodeling in low-flow low-gradient severe aortic stenosis after transcatheter aortic valve implantation[J]. J Am Soc Echocardiogr, 2014, 27(8): 817-825.
[4] BAUMGARTNER H, FALK V, BAX J J, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease[J]. Eur Heart J, 2017, 38(36): 2739-2791.
[5] LANG R M, BADANO L P, MOR-AVI V, et al. Recommendations for cardiac chamber quantification by echocardiography in adults: an update from the American Society of Echocardiography and the European Association of Cardiovascular Imaging[J]. J Am Soc Echocardiogr, 2015, 28(1): 1-39.
[6] 姜胜利, 高长青, 李伯君, 等. 左心室功能严重受损合并跨主动脉瓣压差减低的重度主动脉瓣狭窄患者的外科治疗[J]. 中华胸心血管外科杂志, 2012, 28(7): 415-417.
[7] 杨勇, 刘楠, 侯晓彤. 70岁以上中重度主动脉瓣狭窄患者手术高危因素分析[J]. 心肺血管病杂志, 2016, 35(6): 442-444, 461.
[8] ADDETIA K, TAKEUCHI M, MAFFESSANTI F, et al. Simultaneous longitudinal strain in all 4 cardiac chambers: A novel method for comprehensive functional assessment of the heart[J]. Circ Cardiovasc Imaging, 2016, 9(3): e003895.
[9] NAGATA Y, TAKEUCHI M, WU V C, et al. Prognostic value of LV deformation parameters using 2D and 3D speckle-tracking echocardiography in asymptomatic patients with severe aortic stenosis and preserved LV ejection fraction[J]. JACC Cardiovasc Imaging, 2015, 8(3): 235-245.
[10] 赵映, 李治安, 孙琳, 等. 斑点追踪技术评价重度主动脉瓣狭窄瓣膜置换术前后左室收缩功能[J]. 中国超声医学杂志, 2011, 27(3): 224-227.
[11] 高菡静, 谢明星, 杨莉, 等. 二维斑点追踪显像评价重度主动脉瓣狭窄患者左室壁心肌功能改变[J]. 中华超声影像学杂志, 2013, 22(11): 921-926.
[12] TUMENBAYAR M, YAMAGUCHI K, YOSHITOMI H, et al. Increased apical rotation in patients with severe aortic stenosis assessed by three-dimensional speckle tracking im-aging[J]. J Echocardiogr, 2018, 16(1): 28-33.
[13] 丁钱山, 张平洋, 董静, 等. 三维斑点追踪技术评价左心室射血分数正常的重度主动脉瓣狭窄患者主动脉瓣置换术后左心室心肌功能[J]. 中华医学超声杂志(电子版), 2017, 14(4): 285-291.
[14] 丁钱山, 张平洋, 李林, 等. 三维斑点追踪技术评价射血分数正常的重度主动脉瓣狭窄患者左室心肌收缩特性[J]. 中国超声医学杂志, 2017, 33(2): 128-131.
[15] 陈丽萍, 魏薪, 冯沅, 等. 三维斑点追踪技术评价经导管主动脉瓣植入术患者左心室整体及局部收缩功能[J]. 中华超声影像学杂志, 2014, 23(10): 829-834.
[16] 陈小果, 舒先红. 超声心动图心肌分层应变的临床应用进展[J]. 中华超声影像学杂志, 2016, 25(7): 638-640.
[17] 史静, 潘翠珍, 舒先红, 等. 二维斑点追踪显像技术定量评价正常成年人左心室心肌分层应变[J]. 中华超声影像学杂志, 2015(5): 378-380, 381.
[18] DAHL J S, CHRISTENSEN N L, VIDEBæK L, et al. Left ventricular diastolic function is associated with symptom status in severe aortic valve stenosis[J]. Circ Cardiovasc Imaging, 2014, 7(1): 142-148.
[19] CARSTENSEN H G, LARSEN L H, HASSAGER C, et al. Association of ischemic heart disease to global and regional longitudinal strain in asymptomatic aortic stenosis[J]. Int J Cardiovasc Imaging, 2015, 31(3): 485-495.
[20] ARONSON D, MUTLAK D, BAHOUTH F, et al. Restrictive left ventricular filling pattern and risk of new-onset atrial fibrillation after acute myocardial infarction[J]. Am J Cardiol, 2011, 107(12): 1738-1743.