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目的:采用二维超声斑点追踪成像技术测定高血压患者左心室旋转和扭转运动,评价其临床应用价值。方法:20例正常人和44例原发性高血压患者[包括左心室构型正常组(LVN组)21例和左心室重构组(LVR组)23例]获得心尖水平和基底水平左室短轴清晰二维图像存盘,运用QLAB超声工作站进行脱机分析,得到内膜旋转峰值、外膜旋转峰值、平面旋转峰值及平面扭转峰值,计算左心室整体的扭转峰值。结果:①基底水平:与正常组比较,LVN组内膜旋转峰值、跨壁扭转峰值显著增高(P<0.05);LVR组内膜旋转峰值、平面旋转峰值、跨壁扭转峰值显著增高(P<0.05)。与LVN组比较,LVR组内膜旋转峰值、外膜旋转峰值、平面旋转峰值和跨壁扭转峰值均显著增高(P<0.05)。②心尖水平:与正常组比较,LVR组内膜旋转峰值、平面旋转峰值和跨壁扭转峰值显著增高(P<0.05)。与LVN组比较,LVR组内膜旋转峰值、外膜旋转峰值、平面扭转峰值显著增高(P<0.05)。③左心室整体扭转:与正常组比较和与LVN组比较,LVR组扭转峰值均显著增高(P<0.05)。结论:超声二维斑点追踪显像技术可以准确评价高血压患者左心室旋转和扭转运动,高血压患者旋转与扭转运动力学参数较正常人整体上有明显增高。
OBJECTIVE: To determine left ventricular rotation and torsion in hypertensive patients by two-dimensional ultrasound speckle tracking imaging and evaluate its clinical value. METHODS: Twenty-two normal subjects and 44 patients with essential hypertension (including 21 patients with LVN and 23 patients with left ventricular remodeling (LVR)] received apical and basal levels of left ventricular Short-axis clear two-dimensional image archiving, using QLAB ultrasonic workstation for offline analysis, the endometrial rotation peak, the outer membrane rotation peak, plane rotation peak and plane torsion peak, the calculation of the left ventricular torsion peak. Results: ①The level of basilar membrane: The peak value of intima rotation and transmural torsion in LVN group was significantly higher than that in normal group (P <0.05); the peak value of intima rotation, plane rotation peak and transmural torsion peak in LVN group were significantly increased (P < 0.05). Compared with LVN group, the peak value of intima rotation, peak of outer membrane rotation, peak of plane rotation and peak of transmural torsion were significantly increased in LVR group (P <0.05). ② Apical level: Compared with the normal group, the peak of intima rotation, peak of plane rotation and peak of transmural torsion in LVR group were significantly increased (P <0.05). Compared with LVN group, the peak value of intima rotation, peak of adventitia and peak of plane twist in LVR group were significantly increased (P <0.05). Left ventricular total torsion: Compared with the normal group and LVN group, the peak value of torsion in LVR group was significantly higher (P <0.05). Conclusion: Two-dimensional speckle tracking imaging can accurately evaluate the left ventricular rotation and torsion in hypertensive patients. The parameters of rotation and torsion of hypertensive patients are obviously higher than those of normal subjects.