摘要
目的观察老年冠心病患者心脏超声心动图特征,分析三维空间运动指标与左心室收缩功能的相关性。方法选择2016年1月至2018年1月宝鸡市中心医院收治的65例老年冠心病患者纳入观察组,50例健康志愿者作为对照组,均接受心脏三维超声检查。比较两组受检者心脏三维空间面积应变参数[左心室整体扭转角度峰值(PGT)、左心室整体扭转角度达峰值时间(T_(PGT))、左室基底段扭转角度峰值时间(PBT)、左室基底段扭转角度峰值时间(T_(PBT))、左室中间段扭转角度峰值(PMT)、左室中间段扭转角度峰值(T_(PMT))、左室心尖段扭转角度峰值(PAT)、左室心尖段扭转角度峰值时间(T_(PAT))、左心室整体长轴应变(GLS)]和左心室收缩功能参数[左室射血分数(LVEF)、左室舒张末期容积(LVEDV)和左室收缩末期容积(LVESV)]的差异,分析面积应变参数和左心室收缩功能参数的相关性。结果观察组和对照组受检者的PAT [(9.52±3.65)°vs (11.95±4.52)°]、GLS [(10.32±2.61)%vs (15.34±3.06)%]比较差异均有统计学意义(P<0.05),而PGT、PBT、PMT、T_(PGT)、T_(PBT)、T_(PMT)、T_(PAT)与对照组比较差异均无统计学意义(P>0.05);观察组与对照组受检者的LVEF [(46.38±5.89)%vs (68.02±10.03)%]、LVEDV [(96.35±15.24) mL vs (75.12±10.20) mL]、LVESV [(53.62±12.35) mL vs (35.61±8.15) mL]比较差异均有统计学意义(P<0.05);PGT、PAT、GLS与LVEF呈正相关(r=0.301、0.779、0.695,P<0.05),与LVEDV、LVESV呈负相关[r=(-0.305)~(-0.625),P<0.05]。结论三维超声心动技术对评估老年冠心病患者左心室收缩功能有重要价值,其中心脏扭转面积应变参数PAT、PGT、GLS与LVEF、LVEDV、LVESV有着良好的相关性。
Objective To observe the echocardiographic characteristics of elderly patients with coronary heart disease and analyze the correlation between three-dimensional spatial motion and left ventricular systolic function.Methods Sixty-five elderly patients with coronary heart disease in Baoji Central Hospital from January 2016 to January 2018 were selected as the observation group, and 50 healthy volunteers were selected as the control group. All patients underwent three-dimensional echocardiography. The two groups of patients were compared in three-dimensional strain parameters of cardiac area(peak value of left ventricular global torsion angle [PGT], peak time of left ventricular global torsion angle [T_(PGT)], peak value of left ventricular basal torsion angle [PBT], peak time of left ventricular basal torsion angle [T_(PBT)], peak value of left ventricular middle torsion angle [PMT], peak time of left ventricular middle torsion angle [T_(PMT)], peak value of left ventricular apical torsion angle [PAT], peak time of left ventricular apical torsion angle [T_(PAT)], global long-axis strain [GLS]) and left ventricular systolic function parameters(left ventricular ejection fraction [LVEF], left ventricular end-diastolic volume [LVEDV] and left ventricular end-systolic volume[LVESV]). The correlation between area strain parameters and left ventricular systolic function parameters was analyzed. Results The two groups showed statistically significant difference in PAT and GLS(P<0.05): PAT(9.52 ±3.65)° vs(11.95±4.52)°, GLS(10.32±2.61)% vs(15.34±3.06)%, but they had no significant difference in PGT, PBT,PMT, T_(PGT), T_(PBT), T_(PMT), T_(PAT)(P>0.05). The two groups also showed significant difference in LVEF, LVEDV, LVESV(P<0.05): LVEF,(46.38±5.89)% in the observation group vs(68.02±10.03)% in the control group; LVEDV,(96.35±15.24) m L vs(75.12±10.20) mL; LVESV,(53.62±12.35) mL vs(35.61±8.15) mL. PGT, PAT and GLS were positively correlated with LVEF(r=0.301, 0.779, 0.695, P<0.05) and negatively correlated with LVEDV and LVESV(r=-0.305 to -0.625,P<0.05). Conclusion Three-dimensional echocardiography plays an important role in evaluating left ventricular systolic function in elderly patients with coronary heart disease. PAT, PGT, GLS have good correlation with LVEF, LVEDV, and LVESV.
引文
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