超声心动图二维斑点追踪技术评价慢性阻塞性肺疾病患者右心室收缩功能

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英文篇名：Evaluation of right ventricular systolic function in chronic obstructive pulmonary disease patients by echocardiography two-dimensional speckle tracking technology 作者：刘国文 ; 李嵘娟 ; 肖瑶 ; 朱光发 ; 谢谨捷 ; 杨娅 英文作者：LIU Guowen;LI Rongjuan;XIAO Yao;ZHU Guangfa;XIE Jinjie;YANG Ya;Department of Echocardiography,Beijing Anzhen Hospital,Capital Medical University,Beijing Institute of Heart,Lung and Blood Vessel Diseases; 关键词：二维斑点追踪技术 ; 慢性阻塞性肺疾病 ; 右心室收缩功能 英文关键词：Speckle tracking;;Chronic obstructive pulmonary disease;;Right ventricular 中文刊名：XFXZ 英文刊名：Journal of Cardiovascular and Pulmonary Diseases 机构：首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所超声心动图一部;首都医科大学附属北京安贞医院-北京市心肺血管疾病研究所呼吸及危重症科; 出版日期：2018-06-14 出版单位：心肺血管病杂志 年：2018 期：v.37 基金：国家自然科学基金项目(81671686) 语种：中文; 页：XFXZ201806022 页数：5 CN：06 ISSN：11-3097/R 分类号：89-93

摘要

目的:应用超声心动图二维斑点追踪技术评价慢性阻塞性肺疾病患者(COPD)右心室收缩功能,研究二维斑点追踪技术参数用于评价不同肺动脉高压程度COPD患者右心室收缩功能的可行性。方法:研究纳入COPD患者37例,根据肺动脉收缩压程度分为:肺动脉压正常组,肺动脉高压组。同时选取19例健康成人作为对照组。所有受试者均进行肺功能测定和超声心动图检查,比较三组之间右心室收缩功能的差异。结果:COPD患者无肺动脉高压组和肺动脉高压组的右心室面积变化率,纵向右心室室间隔应变,径向右心室室间隔应变,纵向右心室整体心内膜应变均小于对照组(P<0.05);PH组纵向右心室游离壁应变,纵向右心室室间隔应变,纵向右心室整体心内膜应变小于NPH组(P<0.05);PH组纵向右心室游离壁应变,径向右心室游离壁应变,纵向右室整体心肌应变,径向右室整体心肌应变小于对照组(P<0.05)。结论:超声心动图二维斑点追踪技术可以用于评价COPD患者右心室收缩功能,相比常规的用于评价右心室收缩功能的超声心动图参数更加敏感。
        Objective: To evaluate the right ventricular systolic function in patients with chronic obstructive pulmonary disease( COPD) by echocardiography two-dimensional speckle tracking. The feasibility was studied by two-dimensional speckle tracking technique which can evaluate the right ventricular systolic function in COPD patients with different pulmonary arterial hypertension. Methods: 45 patients with COPD were divided into the normal group of pulmonary artery pressure and the group of pulmonary hypertension according to the degree of systolic pressure of the pulmonary artery. At the same time,21 healthy adults were selected as the control group. All the subjects underwent lung-function testing and echocardiography,and the difference of right ventricular systolic function between the three groups were compared. Results: The fractional area change( FAC),longitudinal right ventricular septum strain( Sep-LS),radial right ventricular septum strain( FW-RS),longitudinal right ventricular globle endocardial( GLS-Endo) strain of COPD patients with no pulmonary hypertension( NPH) and with pulmonary hypertension( PH) were less than the controls( P < 0. 05); The longitudinal right ventricular free wall strain( FW-LS),Sep-LS and GLS-Endo of the PH were less than NPH( P <0. 05); The FW-LS,FW-RS,right ventricle myocardium globle longitudinal strain( RVMyo-GLS),right ventricle myocardium globle radial strain( RVMyo-GRS) of the PH were less than the controls( P < 0. 05). Conclusion: Two dimensional speckle tracking echocardiography can be used to evaluate right ventricular systolic function in patients with COPD,which is more sensitive than conventional echocardiographic parameters.

引文

[1]Claus FV,Gerard JC,Fernando JM,et al.Global strategy for the diagnosis,management,and prevention of chronic obstructive lung disease 2017 report:GOLD executive summary[J].Eur Res J,2017,53(3):128-149.
    [2]赵万桂,张陈,李文秀,等.超声心动图与心导管检查评估肺动脉高压患者血流动力学指标的相关性分析[J].心肺血管病杂志,2017,36(2):119-122.
    [3]Galie N,Humbert M,Vachiery J L,et al.2015 ESC/ERS Guidelines for the diagnosis and treatment of pulmonary hypertension:The Joint Task Force for the Diagnosis and Treatment of Pulmonary Hypertension of the European Society of Cardiology(ESC)and the European Respiratory Society(ERS):Endorsed by:Association for European Paediatric and Congenital Cardiology(AEPC),International Society for Heart and Lung Transplantation(ISHLT)[J].Eur Heart J,2016,37(1):67-119.
    [4]中华医学会呼吸病学分会慢性阻塞性肺疾病学组.慢性阻塞性肺疾病诊治指南(2013年修订版),2014,6(2):67-79.
    [5]彭玲,魏蔚.超声心动图在右心功能评价中的应用[J].中国心血管外科临床杂志,2012,19(6):671-675.
    [6]Calcutteea A,Lindqvist P,Soderberg S,et al.Global and regional right ventricular dysfunction in pulmonary hypertension[J].Echocardiography,2014,31(2):164-171.
    [7]Ikeda S,Tsuneto A,Kojima S,et al.Longitudinal strain of right ventricular free wall by 2-dimensional speckle-tracking echocardiography is useful for detecting pulmonary hypertension[J].Life Sci,2014,111(1-2):12-17.
    [8]Koya Ozawa,Nobusada Funabashi,Nobuhiro Tanabe,et al.Contribution of myocardial layers of right ventricular free wall to right ventricular function in pulmonary hypertension:Analysis using multilayer longitudinal strain by two-dimensional speckle-tracking echocardiography,2016,215(2016):457-462.
    [9]Longobardo L,Suma V,Jain R,et al.Role of two-dimensional speckle-tracking echocardiography strain in the assessment of right ventricular systolic function and comparison with conventional parameters[J].J Am Soc Echocardiogr,2017,30(10):937-946.