论文部分内容阅读
目的运用二维斑点追踪成像(2D-STI)评价射血分数保留的心力衰竭患者(HFPEF)心房间不同步并探讨心房间机械收缩延迟(IAMDs)对HFPEF的预测价值。方法研究分为4组:HFPEF组(n=34)、射血分数降低的心力衰竭(HFREF)组(n=23)、不伴心力衰竭症状的左室舒张功能异常(LVDD)组(n=29)、健康对照组(n=22)。受检者行常规超声检查,计算二尖瓣口舒张早期血流速度与瓣环运动速度比值(E/e′),实时三维超声心动图测量左房最大容积(LAV_(max)),计算左房最大容积指数(LAV_(max) I)。2D-STI测量IAMDs。绘制IAMDs、E/e′及LAV_(max) I的ROC曲线,分析曲线下面积(AUC)。结果与对照组及LVDD组比较,HFPEF组IAMDs明显延长[(28.36±7.09)ms、(38.1±14.48)ms、(55.09±13.43)ms,P<0.05],而HFREF组心房间不同步更加明显(69.55±10.58)ms;ROC曲线显示IAMDs、E/e′及LAV_(max) I的AUC分别为0.856、0.844、0.773。结论2D-STI技术能够准确评价HFPEF患者的心房间不同步,IAMDs可作为预测HFPEF的良好指标。
Objective To evaluate the prediction of HFPEF in patients with congestive heart failure (HFPEF) with preserved ejection fraction by two-dimensional speckle tracking imaging (2D-STI). Methods The study was divided into 4 groups: HFPEF group (n = 34), HFREF group (n = 23), LVDD group without heart failure symptoms (n = 29), healthy control group (n = 22). Subjects underwent routine ultrasound examination to calculate mitral valve diastolic early flow velocity and annulus velocity (E / e ’), real-time three-dimensional echocardiography measured left atrium maximum volume (LAV max), calculate the left Room maximum volume index (LAV_ (max) I). 2D-STI measurement of IAMDs. The ROC curves of IAMDs, E / e ’, and LAV_ (max) I were plotted and the area under the curve (AUC) was analyzed. Results Compared with control group and LVDD group, the IAMDs in HFPEF group were significantly longer than that in control group and LVDD group [(28.36 ± 7.09) ms, (38.1 ± 14.48) ms, (55.09 ± 13.43) ms, P <0.05] (69.55 ± 10.58) ms respectively. The AUC of IAMDs, E / e ’and LAV max (I) were 0.856,0.844,0.773 respectively by ROC curve. Conclusions 2D-STI technique can accurately evaluate the atrial asynchrony in HFPEF patients. IAMDs can be used as a good predictor of HFPEF.