瞬时波强结合全方向M型超声心动图评价高血压心脏-血管整体功能
|
摘要
目的高血压患者常同时存在心脏和血管功能改变,传统超声检查具有局限性,本文应用颈动脉瞬时波强(WI)技术结合全方向M型超声心动图(OME)评价高血压患者的心脏-血管整体功能,探讨WI和OME评价心血管功能的应用价值。资料与方法选择30例健康体检者为对照组;选择原发性高血压患者61例为高血压病组,其中无心肌肥厚组(A组)30例,有心肌肥厚组(B组)31例,应用WI技术测量颈动脉瞬时加速度波强(W1)、瞬时减速度波强(W2)、瞬时波强负向波面积(NA)等,应用OME测量左心室短轴乳头肌水平6个节段的收缩期心内膜运动速度、加速度、相对力。结果 A组及B组的W1分别为(9.918±1.853)mm Hg·m/s~3、(11.710±3.188)mm Hg·m/s~3,NA分别为(31.684±9.109)mmHg·m/s~3、(36.889±10.221)mmHg·m/s~3,均大于对照组的(8.223±1.450)mmHg·m/s~3、(23.673±6.629)mm Hg·m/s~3,差异有统计学意义(P<0.01);B组W1大于A组,差异有统计学意义(P<0.05);A、B组NA差异无统计学意义(P>0.05);3组W2差异无统计学意义(P>0.05);3组收缩期内膜峰值速度和加速度差异无统计学意义(P>0.05),A、B组6个节段的收缩期相对力略大于对照组,但除B组前壁(80.33±13.00)cm2/s~2外,其余各壁差异无统计学意义(P>0.05);A、B组6个节段的收缩期相对力之和分别为(428.75±39.36)cm~2/s~2、(451.70±33.83)cm~2/s~2,大于对照组的(400.51±51.57)cm~2/s~2,差异有统计学意义(P<0.05);B组6个节段的收缩期相对力之和大于A组,差异有统计学意义(P<0.05);3组W1与左心室短轴乳头肌水平6个节段收缩期相对力之和呈正相关(r=0.239,P<0.05)。结论 WI结合OME可全面、综合地评价高血压患者的心脏-血管整体功能。
Purpose Hypertensive patients often experience both cardiac and vascular function changes. Traditional ultrasonography has limitations. This paper applies carotid artery wave intensity(WI) technology combined with omni-directional M-mode echocardiography(OME) to evaluate integral cardiovascular function of patients with hypertension to assess the application of WI and OME in evaluating cardiovascular function. Materials and Methods Thirty healthy subjects were selected as control group; 61 patients with primary hypertension were selected as hypertension group, among which 30 cases were in non-cardiac hypertrophy group(group A), and 31 cases in cardiac hypertrophy group(group B). WI technique was adopted to measure parameters such as transient acceleration wave intensity(W1), transient deceleration wave intensity(W2), and instantaneous wave intensity negative area(NA) of carotid artery. OME was used to measure parameters such as velocity, accelerated velocity, and relative force of systolic endocardium of the six segments of left ventricular short-axis papillary muscles level. Results W1 and NA of hypertension group A and B were higher than those of the control group [W1:(9.918±1.853) mmHg·m/s~3 vs.(11.710±3.188)mmHg·m/s~3 vs.(8.223±1.450) mmHg·m/s~3; NA:(31.684±9.109)mmHg·m/s~3 vs.(36.889±10.221)mmHg·m/s~3 vs.(23.673±6.629)mmHg·m/s~3, P<0.01]. W1 in group B was greater than that in group A, the difference of which was statistically significant(P<0.05). The difference of NA between groups A and B was not statistically significant(P>0.05). The difference of W2 among the three groups was not statistically significant(P>0.05). The difference of peak velocity and accelerated velocity of systolic endocardium among the three groups was not statistically significant(P>0.05). The systolic relative forces of the six segments in group A and B were slightly larger than those in control group, except for the anterior wall of group B(80.33±13.00)cm~2/s~2, and the difference among other walls was not statistically significant(P>0.05); the sum of systolic relative force of the six segments in group A and B was greater than that in control group [(428.75±39.36)cm~2/s~2 ratio(451.70±33.83) cm~2/s~2] vs.(400.51±51.57) cm~2/s~2, P<0.05]; the sum of systolic relative force of the six segments in group B was greater than that in group A(P<0.05), the difference of which was statistically significant; W1 and the sum of systolic relative force of the six segments of left ventricular short-axis papillary muscle in three groups were correlated(r=0.239, P<0.05). Conclusion WI combined with OME can comprehensively evaluate cardiovascular function of hypertensive patients.
Purpose Hypertensive patients often experience both cardiac and vascular function changes. Traditional ultrasonography has limitations. This paper applies carotid artery wave intensity(WI) technology combined with omni-directional M-mode echocardiography(OME) to evaluate integral cardiovascular function of patients with hypertension to assess the application of WI and OME in evaluating cardiovascular function. Materials and Methods Thirty healthy subjects were selected as control group; 61 patients with primary hypertension were selected as hypertension group, among which 30 cases were in non-cardiac hypertrophy group(group A), and 31 cases in cardiac hypertrophy group(group B). WI technique was adopted to measure parameters such as transient acceleration wave intensity(W1), transient deceleration wave intensity(W2), and instantaneous wave intensity negative area(NA) of carotid artery. OME was used to measure parameters such as velocity, accelerated velocity, and relative force of systolic endocardium of the six segments of left ventricular short-axis papillary muscles level. Results W1 and NA of hypertension group A and B were higher than those of the control group [W1:(9.918±1.853) mmHg·m/s~3 vs.(11.710±3.188)mmHg·m/s~3 vs.(8.223±1.450) mmHg·m/s~3; NA:(31.684±9.109)mmHg·m/s~3 vs.(36.889±10.221)mmHg·m/s~3 vs.(23.673±6.629)mmHg·m/s~3, P<0.01]. W1 in group B was greater than that in group A, the difference of which was statistically significant(P<0.05). The difference of NA between groups A and B was not statistically significant(P>0.05). The difference of W2 among the three groups was not statistically significant(P>0.05). The difference of peak velocity and accelerated velocity of systolic endocardium among the three groups was not statistically significant(P>0.05). The systolic relative forces of the six segments in group A and B were slightly larger than those in control group, except for the anterior wall of group B(80.33±13.00)cm~2/s~2, and the difference among other walls was not statistically significant(P>0.05); the sum of systolic relative force of the six segments in group A and B was greater than that in control group [(428.75±39.36)cm~2/s~2 ratio(451.70±33.83) cm~2/s~2] vs.(400.51±51.57) cm~2/s~2, P<0.05]; the sum of systolic relative force of the six segments in group B was greater than that in group A(P<0.05), the difference of which was statistically significant; W1 and the sum of systolic relative force of the six segments of left ventricular short-axis papillary muscle in three groups were correlated(r=0.239, P<0.05). Conclusion WI combined with OME can comprehensively evaluate cardiovascular function of hypertensive patients.
引文
[1]Ohte N,Narita H,Sugawara M,et al.Clinical usefulness of carotid arterial wave intensity in assessing left ventricular systolic and early diastolic performance.Heart Vessels,2003,18(3):107-111.
[2]马红.瞬时波强在心血管疾病中的应用进展.中国医学影像学杂志,2014,22(7):551-553.
[3]林强,石江宏.超声心动图的一种动态信息-全方向M型心动图.仪器仪表学报,2005,26(4):437-440.
[4]刘力生.中国高血压防治指南2010.中华心血管病杂志,2011,39(7):701-708.
[5]周亚芹,何峥,高志玲.瞬时波强技术评价2型糖尿病患者早期心血管功能变化的研究.中国医师杂志,2015,17(4):551-553.
[6]Niki K,Sugawara M,Kayanuma H,et al.Associations of increased arterial stiffness with left ventricular ejection performance and right ventricular systolic pressure in mitral regurgitation before and after surgery:wave intensity analysis.Int J Cardiol Heart Vasc,2017,16(C):7-13.
[7]关晓韵,张文华,翟军,等.瞬时波强技术评价高血压患者左心结构功能与颈动脉弹性变化探讨.中国心血管杂志,2015,20(3):192-195.
[8]Li Y,Guo L.Clinical value of carotid wave intensity analysis for differentiating nonobstructive hypertrophic cardiomyopathy from left ventricular hypertrophy secondary to systemic hypertension.J Clin Ultrasound,2013,41(3):151-157.
[9]Iwado Y,Mizushige K,Watanabe K,et al.Quantitative analysis of myocardial response to dobutamine by measurement of left ventricular wall motion using omnidirectional M-mode echocardiography.Am J Cardiol,1999,83(5):765-769.
[10]郭薇,王春,卢荔红.LEJ-1型全方向-M型超声心动图对心室壁运动速度与加速度的研究.中国超声医学杂志,2006,22(9):665-667.
[2]马红.瞬时波强在心血管疾病中的应用进展.中国医学影像学杂志,2014,22(7):551-553.
[3]林强,石江宏.超声心动图的一种动态信息-全方向M型心动图.仪器仪表学报,2005,26(4):437-440.
[4]刘力生.中国高血压防治指南2010.中华心血管病杂志,2011,39(7):701-708.
[5]周亚芹,何峥,高志玲.瞬时波强技术评价2型糖尿病患者早期心血管功能变化的研究.中国医师杂志,2015,17(4):551-553.
[6]Niki K,Sugawara M,Kayanuma H,et al.Associations of increased arterial stiffness with left ventricular ejection performance and right ventricular systolic pressure in mitral regurgitation before and after surgery:wave intensity analysis.Int J Cardiol Heart Vasc,2017,16(C):7-13.
[7]关晓韵,张文华,翟军,等.瞬时波强技术评价高血压患者左心结构功能与颈动脉弹性变化探讨.中国心血管杂志,2015,20(3):192-195.
[8]Li Y,Guo L.Clinical value of carotid wave intensity analysis for differentiating nonobstructive hypertrophic cardiomyopathy from left ventricular hypertrophy secondary to systemic hypertension.J Clin Ultrasound,2013,41(3):151-157.
[9]Iwado Y,Mizushige K,Watanabe K,et al.Quantitative analysis of myocardial response to dobutamine by measurement of left ventricular wall motion using omnidirectional M-mode echocardiography.Am J Cardiol,1999,83(5):765-769.
[10]郭薇,王春,卢荔红.LEJ-1型全方向-M型超声心动图对心室壁运动速度与加速度的研究.中国超声医学杂志,2006,22(9):665-667.