目的 探索压力-应变环(PSL)定量评价慢性心力衰竭(CHF)患者的右室心肌做功情况。方法 选取2021-12至2022-06在荆州市中心医院临床确诊的CHF患者60例为病例组,根据肺动脉收缩压(PASP)是否＞40 mmHg分为非肺动脉高压组(NPH组)与肺动脉高压组(PH组),同期选取30例健康志愿者作为对照组。所有研究对象均进行常规超声心动图检查,获取常规超声参数:右室面积变化分数(RVFAC)、三尖瓣环收缩期峰值速度(S')、三尖瓣环收缩期位移(TAPSE)等。通过EchoPAC工作站获得右室整体纵向应变(RVGLS)及右室心肌做功参数,包括右室整体做功指数(RVGWI)、右室整体有用功(RVGCW)、右室整体无用功(RVGWW)、右室整体做功效率(RVGWE),并比较三组间各参数的差异。结果 与对照组比较,NPH组、PH组RVFAC、S'、TAPSE减低,RVGLS、RVGWI、RVGCW、RVGWE减低,RVGWW增高,差异均有统计学意义(P＜0.05)。与NPH组比较,PH组RVFAC、S'、TAPSE差异均无统计学意义,RVGLS减低,RVGWI、RVGCW、RVGWW增高,差异均有统计学意义(P＜0.05),RVGWE差异无统计学意义。结论 PSL不受后负荷的影响,能及早发现CHF患者的右室心肌收缩功能异常,为评估心肌受累程度提供了一种新的方法。
Abstract
Objective To explore the quantitative evaluation of right ventricular myocardial work in patients with chronic heart failure (CHF) by pressure-strain loop (PSL).Methods Sixty patients with clinically confirmed CHF in Jingzhou Central Hospital from December 2021 to June 2022 were selected as the case group. and they were divided into non-pulmonary hypertension group (NPH group) and pulmonary hypertension group (PH group) according to whether the pulmonary artery systolic pressure (PASP) was >40 mmHg, and thirty healthy volunteers were selected as the control group during the same period. All study subjects underwent routine echocardiography to obtain routine ultrasound parameters: right ventricular area change fraction (RVFAC), tricuspid annular peak systolic velocity (S'), and tricuspid annular plane systolic excursion (TAPSE), etc. Right ventricular global longitudinal strain (RVGLS) and right ventricular myocardial work parameters were obtained by EchoPAC work station, including right ventricle global work index (RVGWI), right ventricle global constructive work (RVGCW), right ventricle global wasted work (RVGWW) and right ventricle global work efficiency (RVGWE), and the differences of each parameter between the three groups were compared.Results Compared with the control group, RVFAC, S', and TAPSE decreased, RVGLS, RVGWI, RVGCW, and RVGWE also decreased, and RVGWW increased in the NPH and PH groups, with statistically significant differences (P<0.05).Compared with the NPH group, there were no statistical differences in RVFAC, S', and TAPSE, RVGLS decreased, RVGWI, RVGCW and RVGWW increased with statistically significant differences(P<0.05), and there were no statistical differences in RVGWE.Conclusions PSL is independent of afterload and available to detect abnormal right ventricular myocardial systolic function early in patients with CHF, providing a novel evaluation method for assessing the degree of myocardial involvement.
关键词
超声心动图 /
压力-应变环 /
心力衰竭 /
右心室 /
心肌做功
Key words
echocardiography /
pressure-strain loop /
heart failure /
right ventricle /
myocardial work
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参考文献
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